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General NPI Number Information
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NPI Number | 1669867560
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Entity Type | Organization
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Legal Business Name | SUSAN J. HARRIS, INC.
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Dates
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Enumeration Date | 03/30/2015
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Last Update Date | 03/30/2015
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Provider Practice Location Address
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Address Line | 2751 ROOSEVELT RD SUITE 203
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City | SAN DIEGO
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State | CA
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Zip | 92106-6180
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Country | US
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Telephone | 619-501-9755
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Fax |
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Provider Business Mailing Address
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Address Line | 3760 CONVOY ST SUITE 204
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City | SAN DIEGO
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State | CA
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Zip | 92111-3742
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Country | US
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Telephone | 858-514-0375
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Fax |
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Authorized Official
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Title or Position | HR COORDINATOR
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Name | MS. JESSICA LYNN WOODY
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Credential |
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Telephone | 858-514-0375
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State | CA
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