Healthcare Provider Details

I. General information

NPI: 1629376322
Provider Name (Legal Business Name): SUSANNE SEMLER BIRMAN R.N., C.N.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/03/2011
Last Update Date: 03/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3620 SAINT ELIZABETH RD
GLENDALE CA
91206-1228
US

IV. Provider business mailing address

3620 SAINT ELIZABETH RD
GLENDALE CA
91206-1228
US

V. Phone/Fax

Practice location:
  • Phone: 818-790-9907
  • Fax: 818-799-0990
Mailing address:
  • Phone: 818-790-9907
  • Fax: 818-799-0990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number578
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: