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General NPI Number Information
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NPI Number | 1326355934
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Entity Type | Individual
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Provider Name | SARAH I SUSSEN
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Gender | Female
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Dates
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Enumeration Date | 09/02/2010
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Last Update Date | 05/29/2015
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Provider Practice Location Address
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Address Line | 900 N SAN ANTONIO RD SUITE #217
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City | LOS ALTOS
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State | CA
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Zip | 94022-1373
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Country | US
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Telephone | 408-390-3493
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Fax |
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Provider Business Mailing Address
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Address Line | 10642 LARRY WAY
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City | CUPERTINO
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State | CA
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Zip | 95014-2057
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Country | US
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Telephone | 408-390-3493
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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