Healthcare Provider Details

I. General information

NPI: 1356036040
Provider Name (Legal Business Name): SUZANNE VUE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2023
Last Update Date: 08/13/2024
Certification Date: 08/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 BARTLETT ST
SAN FRANCISCO CA
94110-3807
US

IV. Provider business mailing address

375 89TH ST
DALY CITY CA
94015-1802
US

V. Phone/Fax

Practice location:
  • Phone: 916-642-6378
  • Fax:
Mailing address:
  • Phone: 650-301-8650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: