Healthcare Provider Details

I. General information

NPI: 1982535514
Provider Name (Legal Business Name): ELENA COSIO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 PIONEER DR UNIT 104
GLENDALE CA
91203-2741
US

IV. Provider business mailing address

345 PIONEER DR UNIT 104
GLENDALE CA
91203-2741
US

V. Phone/Fax

Practice location:
  • Phone: 818-731-3349
  • Fax: 747-777-8813
Mailing address:
  • Phone: 818-731-3349
  • Fax: 747-777-8813

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN503179
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: