Healthcare Provider Details

I. General information

NPI: 1326973041
Provider Name (Legal Business Name): SUDEENE ALVARANGA FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1231 S HILL ST
LOS ANGELES CA
90015-4177
US

IV. Provider business mailing address

1231 S HILL ST APT 483
LOS ANGELES CA
90015-4258
US

V. Phone/Fax

Practice location:
  • Phone: 424-744-9330
  • Fax:
Mailing address:
  • Phone: 424-744-9330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95039120
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: