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General NPI Number Information
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NPI Number | 1962862870
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Entity Type | Individual
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Provider Name | SUSAN J WARD MS, NUTRITION
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Gender | Female
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Dates
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Enumeration Date | 03/04/2016
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Last Update Date | 03/04/2016
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Provider Practice Location Address
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Address Line | 1122 W BURBANK BLVD
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City | BURBANK
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State | CA
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Zip | 91506-1414
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Country | US
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Telephone | 818-736-9889
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Fax |
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Provider Business Mailing Address
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Address Line | 302 WASHINGTON ST 246
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City | SAN DIEGO
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State | CA
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Zip | 92103-2110
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Country | US
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Telephone | 310-367-8045
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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 | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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