Individual
MRS. BRENDA ANN DACOSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5850 S MAIN ST, LOS ANGELES, CA 90003-1215
(323) 846-4265
(323) 232-8115
Mailing address
490 PINE AVE APT 408-P, LONG BEACH, CA 90802-2386
(562) 432-0410
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
11432
CA
Other
Enumeration date
01/24/2007
Last updated
07/08/2007
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