Provider Demographics
NPI:1285955377
Name:UDENZE, EUCHARIA
Entity type:Individual
Prefix:
First Name:EUCHARIA
Middle Name:
Last Name:UDENZE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4226 W 164TH ST
Mailing Address - Street 2:
Mailing Address - City:LAWNDALE
Mailing Address - State:CA
Mailing Address - Zip Code:90260-2919
Mailing Address - Country:US
Mailing Address - Phone:323-602-9143
Mailing Address - Fax:
Practice Address - Street 1:4226 W 164TH ST
Practice Address - Street 2:
Practice Address - City:LAWNDALE
Practice Address - State:CA
Practice Address - Zip Code:90260-2919
Practice Address - Country:US
Practice Address - Phone:323-602-9143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-13
Last Update Date:2010-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA771856163W00000X
CA224553164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
No163W00000XNursing Service ProvidersRegistered Nurse