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General NPI Number Information
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NPI Number | 1346113644
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Entity Type | Organization
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Legal Business Name | SLR PROFESSIONAL NURSING CORP
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Dates
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Enumeration Date | 09/24/2025
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 1525 SUPERIOR AVE STE 200
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City | NEWPORT BEACH
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State | CA
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Zip | 92663-3639
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Country | US
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Telephone | 949-229-3369
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Fax |
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Provider Business Mailing Address
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Address Line | 895 RONDA SEVILLA UNIT B
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City | LAGUNA WOODS
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State | CA
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Zip | 92637-4797
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SUSANNAH ROGERS
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Credential | PMHNP-BC
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Telephone | 949-874-3391
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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