Individual
DEJANIQUE EDITH HUDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1060 MANOR RD, EL SOBRANTE, CA 94803-1336
(510) 236-0444
Mailing address
4892 SAN PABLO DAM RD, EL SOBRANTE, CA 94803-3222
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
172V00000X
Community Health Worker
—
—
225400000X
Rehabilitation Practitioner
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
10/12/2021
Last updated
05/27/2025
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