Healthcare Provider Details

I. General information

NPI: 1013801232
Provider Name (Legal Business Name): SUZANNE LEA SCHREIBER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2025
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13448 BEACH AVE APT 3306
MARINA DEL REY CA
90292-7743
US

IV. Provider business mailing address

13448 BEACH AVE APT 3306
MARINA DEL REY CA
90292-7743
US

V. Phone/Fax

Practice location:
  • Phone: 970-319-3471
  • Fax:
Mailing address:
  • Phone: 970-319-3471
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number95190
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: