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General NPI Number Information
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NPI Number | 1346396132
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Entity Type | Individual
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Provider Name | SUZAN VICTORIA SOUTH RNP
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Gender | Female
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7345 MEDICAL CENTER DR
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City | WEST HILLS
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State | CA
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Zip | 91307-1910
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Country | US
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Telephone | 818-348-6200
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Fax | 818-348-6233
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Provider Business Mailing Address
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Address Line | 6208 ORION AVE
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City | VAN NUYS
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State | CA
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Zip | 91411-1022
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Country | US
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Telephone | 818-994-1943
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Fax | 818-994-1999
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | RN484250 NP6940
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License Number State | CA
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