Healthcare Provider Details

I. General information

NPI: 1073893285
Provider Name (Legal Business Name): SUZANNE KATHRYN ROMEO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2011
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 W CENTRAL AVE
LOMPOC CA
93436-2805
US

IV. Provider business mailing address

910 E STOWELL RD
SANTA MARIA CA
93454-7001
US

V. Phone/Fax

Practice location:
  • Phone: 805-736-2020
  • Fax: 805-737-1733
Mailing address:
  • Phone: 805-925-2637
  • Fax: 805-925-3617

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number15368
License Number StateCA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: