Active NPI
Kayla Danielle Hudson
- Marriage & Family Therapist
- Riverside, CA
National Provider Identifier
1386468270
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 147721
- Practice address
- 2085 Rustin Ave
Riverside, CA 92507-2498 - Phone
- (951) 955-8000
- NPI assigned
- Nov 8, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 16871 | CA | |
| Marriage & Family Therapist | 106H00000X | 147721 | CA | Primary |
Addresses
Primary practice location
2085 Rustin Ave
Riverside, CA 92507-2498
Mailing address
3670 N G St
San Bernardino, CA 92405-2056
Phone (909) 380-9840
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 147721 | CA | MD | Marriage & Family Therapist |
| 16871 | CA | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1731024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731024000000",
"number": "1386468270",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3670 N G ST",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924052056",
"telephone_number": "909-380-9840"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2085 RUSTIN AVE",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925072498",
"telephone_number": "951-955-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUDSON",
"first_name": "KAYLA",
"middle_name": "DANIELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-11-08",
"last_updated": "2024-11-08",
"certification_date": "2024-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CA",
"license": "16871",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "147721",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.