Provider Demographics
NPI:1619501855
Name:CODIGA, SUZANNE (RN)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:CODIGA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:645 W 9TH ST # 110-287
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90015-1640
Mailing Address - Country:US
Mailing Address - Phone:310-869-4779
Mailing Address - Fax:
Practice Address - Street 1:801 S OLIVE ST APT 716
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90014-3022
Practice Address - Country:US
Practice Address - Phone:310-869-4779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-26
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA564894163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health