Provider Demographics
NPI:1730573395
Name:GODOY, APOLLONIA (NP)
Entity type:Individual
Prefix:MRS
First Name:APOLLONIA
Middle Name:
Last Name:GODOY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:APOLLONIA
Other - Middle Name:
Other - Last Name:MENDOZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:222 N. TOLUCA ST
Mailing Address - Street 2:APT 3.
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90026
Mailing Address - Country:US
Mailing Address - Phone:213-864-0616
Mailing Address - Fax:
Practice Address - Street 1:1670 E. 120TH ST
Practice Address - Street 2:4TH FLOOR, MODULE A
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90059
Practice Address - Country:US
Practice Address - Phone:424-338-1000
Practice Address - Fax:310-223-0192
Is Sole Proprietor?:No
Enumeration Date:2015-03-22
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95004949163W00000X, 363LP2300X
NY688579163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse