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General NPI Number Information
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NPI Number | 1053789446
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Entity Type | Individual
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Provider Name | SUSI GARAY ZECENA RN, BSN, MSN, PMHNP
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Gender | Female
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Dates
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Enumeration Date | 09/02/2015
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Last Update Date | 04/16/2026
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Provider Practice Location Address
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Address Line | 855 S MAIN AVE STE K
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City | FALLBROOK
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State | CA
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Zip | 92028-3351
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Country | US
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Telephone | 310-701-7624
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Fax |
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Provider Business Mailing Address
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Address Line | 855 S MAIN AVE STE K
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City | FALLBROOK
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State | CA
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Zip | 92028-3351
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Country | US
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Telephone | 310-701-7624
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 95141591
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 95031588
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License Number State | CA
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