Provider Demographics
NPI:1568249126
Name:PARRA, TANIA GUADALUPE
Entity Type:Individual
Prefix:
First Name:TANIA
Middle Name:GUADALUPE
Last Name:PARRA
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 1:4323 SANTA ANA ST
Mailing Address - Street 2:
Mailing Address - City:CUDAHY
Mailing Address - State:CA
Mailing Address - Zip Code:90201-5715
Mailing Address - Country:US
Mailing Address - Phone:323-631-1237
Mailing Address - Fax:
Practice Address - Street 1:21707 HAWTHORNE BLVD
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-7009
Practice Address - Country:US
Practice Address - Phone:310-543-9900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-08
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program