Healthcare Provider Details

I. General information

NPI: 1639028368
Provider Name (Legal Business Name): JOSELIN ALEMAN SUDRC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2026
Last Update Date: 01/26/2026
Certification Date: 01/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4363 TWEEDY BLVD
SOUTH GATE CA
90280-6236
US

IV. Provider business mailing address

4363 TWEEDY BLVD
SOUTH GATE CA
90280-6236
US

V. Phone/Fax

Practice location:
  • Phone: 323-378-2009
  • Fax: 213-395-9592
Mailing address:
  • Phone: 323-378-2009
  • Fax: 213-395-9592

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number24554
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: