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NPI Code Detail

MEDICARE: SUZAN RANDA ABBOUD

MEDICARE: SUZAN RANDA ABBOUD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage Therapist35165CA
2171400000XHealth & Wellness Coach

General Provider Information

NPI Number : 1518517861
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUZAN RANDA ABBOUD
Provider Business Mailing Address
First Line : 5657 8TH AVE
Second Line :
City : SACRAMENTO
State : CA
Zip : 95820-1723
Country : US
Telephone Number : 831-596-2120
Fax Number :
Provider Business Practice Location Address
First Line : 330 N BRAND BLVD STE 700
Second Line :
City : GLENDALE
State : CA
Zip : 91203-2336
Country : US
Telephone Number : 800-516-0975
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/18/2019
Last Update Date : 10/03/2024

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Directions to “ SUZAN RANDA ABBOUD ” Practice Location

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