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General NPI Number Information
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NPI Number | 1114877909
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Entity Type | Individual
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Provider Name | SUZETTE VERBECK RN
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Gender | Female
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Dates
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Enumeration Date | 01/30/2026
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Last Update Date | 01/30/2026
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Provider Practice Location Address
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Address Line | 104 LA SALLE
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City | SAN CLEMENTE
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State | CA
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Zip | 92672-7516
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Country | US
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Telephone | 706-814-0533
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Fax |
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Provider Business Mailing Address
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Address Line | 104 LA SALLE
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City | SAN CLEMENTE
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State | CA
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Zip | 92672-7516
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Country | US
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Telephone | 706-814-0533
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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 | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | 95405108
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License Number State | CA
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