Provider Demographics
NPI:1427163138
Name:HUDSON, PATRICIA OLWEN (PHD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:OLWEN
Last Name:HUDSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12451 CURRY CT
Mailing Address - Street 2:
Mailing Address - City:SARATOGA
Mailing Address - State:CA
Mailing Address - Zip Code:95070-3502
Mailing Address - Country:US
Mailing Address - Phone:361-688-2248
Mailing Address - Fax:
Practice Address - Street 1:12451 CURRY CT
Practice Address - Street 2:
Practice Address - City:SARATOGA
Practice Address - State:CA
Practice Address - Zip Code:95070-3502
Practice Address - Country:US
Practice Address - Phone:361-688-2248
Practice Address - Fax:361-904-0465
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13753101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1769366Medicaid