Healthcare Provider Details

I. General information

NPI: 1760333231
Provider Name (Legal Business Name): MRS. ANNA SUDIT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2026
Last Update Date: 02/09/2026
Certification Date: 02/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4070 MISSION AVE
OCEANSIDE CA
92057-6402
US

IV. Provider business mailing address

PO BOX 18016
IRVINE CA
92623-8016
US

V. Phone/Fax

Practice location:
  • Phone: 442-262-3249
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number250155927
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: