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General NPI Number Information
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NPI Number | 1861949273
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Entity Type | Individual
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Provider Name | SUSANA PREZA NP
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Gender | Female
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Dates
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Enumeration Date | 09/01/2016
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Last Update Date | 09/01/2016
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Provider Practice Location Address
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Address Line | 757 WESTWOOD PLZ STE 5235E
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City | LOS ANGELES
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State | CA
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Zip | 90095-8358
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Country | US
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Telephone | 310-267-8079
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Fax |
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Provider Business Mailing Address
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Address Line | 8603 JELLICO AVE
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City | SHERWOOD FOREST
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State | CA
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Zip | 91325-3103
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Country | US
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Telephone | 818-445-4401
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Fax |
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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 | NPF21427
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License Number State | CA
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