Provider Demographics
NPI:1013892975
Name:GUKOVA, MARYNA (RN)
Entity type:Individual
Prefix:
First Name:MARYNA
Middle Name:
Last Name:GUKOVA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5951 MATILIJA AVE APT 1/2
Mailing Address - Street 2:
Mailing Address - City:VALLEY GLEN
Mailing Address - State:CA
Mailing Address - Zip Code:91401-4428
Mailing Address - Country:US
Mailing Address - Phone:626-272-9421
Mailing Address - Fax:
Practice Address - Street 1:12037 RIALTO ST
Practice Address - Street 2:
Practice Address - City:SUN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91352-3042
Practice Address - Country:US
Practice Address - Phone:626-272-9421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-09
Last Update Date:2025-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95414550163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse