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General NPI Number Information
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NPI Number | 1538167861
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Entity Type | Individual
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Provider Name | SUSANNE JOHNSON PHILLIPS DNP, FNP
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Gender | Female
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Dates
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Enumeration Date | 07/11/2005
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Last Update Date | 06/25/2015
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Provider Practice Location Address
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Address Line | 300 W CARL KARCHER WAY
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City | ANAHEIM
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State | CA
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Zip | 92801-2426
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Country | US
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Telephone | 888-456-7002
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Fax | 714-435-5407
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Provider Business Mailing Address
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Address Line | UNIVERSITY OF CALIFORNIA IRVINE 252E BERK HALL
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City | IRVINE
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State | CA
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Zip | 92697-3959
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Country | US
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Telephone | 949-824-4274
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Fax | 949-824-0470
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN476058 NP8130
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License Number State | CA
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