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General NPI Number Information
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NPI Number | 1467914952
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Entity Type | Individual
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Provider Name | SUSAN E. OCEAN PHD
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Gender | Female
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Dates
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Enumeration Date | 04/03/2019
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Last Update Date | 03/11/2024
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Provider Practice Location Address
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Address Line | MSC09 - 5030 1 UNIVERSITY OF NEW MEXICO
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City | ALBUQUERQUE
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State | NM
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Zip | 87131-0001
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Country | US
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Telephone | 406-285-8870
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Fax |
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Provider Business Mailing Address
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Address Line | 601 CHILDRENS LN
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City | NORFOLK
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State | VA
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Zip | 23507-1971
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Country | US
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Telephone | 757-668-4673
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Fax | 757-668-8870
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0810008166
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License Number State | VA
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