Healthcare Provider Details

I. General information

NPI: 1508777517
Provider Name (Legal Business Name): SUSAN ANNELIESE LUNDIN MS, PPS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21380 CENTRE POINTE PKWY
SANTA CLARITA CA
91350-3050
US

IV. Provider business mailing address

21380 CENTRE POINTE PKWY
SANTA CLARITA CA
91350-3050
US

V. Phone/Fax

Practice location:
  • Phone: 661-259-0033
  • Fax: 661-254-8653
Mailing address:
  • Phone: 661-259-0033
  • Fax: 661-254-8653

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number230038992
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: