Provider Demographics
NPI:1821734120
Name:MORALES, MA SUZANNE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:MA SUZANNE
Middle Name:
Last Name:MORALES
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:MA SUZANNE
Other - Middle Name:
Other - Last Name:BADUA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10652 PARAMOUNT BLVD
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-3304
Mailing Address - Country:US
Mailing Address - Phone:562-650-9616
Mailing Address - Fax:
Practice Address - Street 1:10652 PARAMOUNT BLVD
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-3304
Practice Address - Country:US
Practice Address - Phone:562-650-9616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-09
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA678436363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily