Doctor Name: | MS. JUDY ANN BORDEAUX |
NPI Number: | 1003144924 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MFTT |
License Number: | |
Business Practice Address: | 131 W Midway Dr Anaheim, CA - 928056507 |
Business Phone Number: | 7145177107 |
Business Fax Number: | |
Mailing Address: | 131 W Midway Dr, ANAHEIM |
State: | CA |
Postal Code: | 928056507 |
Phone Number: | 7145177107 |
Fax Number: | |
NPI Enumeration Date: | 12/04/2009 |
NPI Last Update Date: | 12/04/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |