Provider Demographics
NPI:1871612234
Name:KAYA, JUDI
Entity type:Individual
Prefix:MS
First Name:JUDI
Middle Name:
Last Name:KAYA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2337 ROBLE AVE
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95354-1807
Mailing Address - Country:US
Mailing Address - Phone:209-544-8250
Mailing Address - Fax:
Practice Address - Street 1:2337 ROBLE AVE
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95354-1807
Practice Address - Country:US
Practice Address - Phone:209-544-8250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)