Provider Demographics
NPI:1194693457
Name:DUDLEY REALTY SERVICE LLC
Entity type:Organization
Organization Name:DUDLEY REALTY SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:NATHANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DUDLEY
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:510-290-8314
Mailing Address - Street 1:184 TURNBERRY WAY
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94591-4326
Mailing Address - Country:US
Mailing Address - Phone:510-290-8314
Mailing Address - Fax:
Practice Address - Street 1:219 SAGE ST
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94589-2035
Practice Address - Country:US
Practice Address - Phone:510-290-8314
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-28
Last Update Date:2025-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty