Active NPI
Susan Lynn Coda Taus, NP
- Family Nurse Practitioner
- Cerritos, CA
National Provider Identifier
1588964761
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 19894
- Practice address
- 12900 Park Plaza Dr
Cerritos, CA 90703-9329 - Phone
- (866) 646-3553
- Fax
- (562) 622-3058
- NPI assigned
- Oct 22, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 19894 | CA | Primary |
Addresses
Primary practice location
12900 Park Plaza Dr
Cerritos, CA 90703-9329
Mailing address
26730 Menominee Place
Rancho Palos Verdes, CA 90275
Phone (310) 809-7018
Other names 1
- Susan Lynn Coda
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464739200000",
"number": "1588964761",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26730 MENOMINEE PLACE",
"city": "RANCHO PALOS VERDES",
"state": "CA",
"postal_code": "90275",
"telephone_number": "310-809-7018"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12900 PARK PLAZA DR",
"city": "CERRITOS",
"state": "CA",
"postal_code": "907039329",
"telephone_number": "866-646-3553",
"fax_number": "562-622-3058"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CODA TAUS",
"first_name": "SUSAN",
"middle_name": "LYNN",
"credential": "NP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-10-22",
"last_updated": "2016-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "19894",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SUSAN",
"last_name": "CODA",
"middle_name": "LYNN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Cerritos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.