Provider Demographics
NPI:1649570953
Name:CZUBIAK, MARION JANET (RN)
Entity Type:Individual
Prefix:
First Name:MARION
Middle Name:JANET
Last Name:CZUBIAK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:MARION
Other - Middle Name:CARPENEDO
Other - Last Name:CZUBIAK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:550 S VERMONT AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-1912
Mailing Address - Country:US
Mailing Address - Phone:213-639-6315
Mailing Address - Fax:213-738-4646
Practice Address - Street 1:550 S VERMONT AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-1912
Practice Address - Country:US
Practice Address - Phone:213-639-6315
Practice Address - Fax:213-738-4646
Is Sole Proprietor?:No
Enumeration Date:2010-11-02
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA197640163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health