Provider Demographics
NPI:1184180689
Name:SANGUINO, NIDIA (CLIENT ENGAGEMENT)
Entity Type:Individual
Prefix:
First Name:NIDIA
Middle Name:
Last Name:SANGUINO
Suffix:
Gender:F
Credentials:CLIENT ENGAGEMENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2330 BEVERLY BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-2220
Mailing Address - Country:US
Mailing Address - Phone:213-381-0518
Mailing Address - Fax:
Practice Address - Street 1:2330 BEVERLY BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-2220
Practice Address - Country:US
Practice Address - Phone:213-981-0518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-20
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program