Provider Demographics
NPI:1528333853
Name:SUAREZ CORTEZ, BRENDA GUADALUPE (BA)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:GUADALUPE
Last Name:SUAREZ CORTEZ
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:BRENDA
Other - Middle Name:
Other - Last Name:SUAREZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BA
Mailing Address - Street 1:121 W 15TH ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90813-1803
Mailing Address - Country:US
Mailing Address - Phone:562-235-4024
Mailing Address - Fax:
Practice Address - Street 1:2939 E PACIFIC COMMERCE DR
Practice Address - Street 2:
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90221-5729
Practice Address - Country:US
Practice Address - Phone:310-631-0793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-20
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker