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NPI Code Detail

MEDICARE: MS. SUSAN OSBORNE LMFT

MEDICARE: MS. SUSAN OSBORNE LMFT
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
1106H00000XMarriage & Family TherapistMFC39201CA

General Provider Information

NPI Number : 1710015896
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SUSAN OSBORNE LMFT
Provider Business Mailing Address
First Line : 200 PINE AVE STE 400
Second Line :
City : LONG BEACH
State : CA
Zip : 90802-3039
Country : US
Telephone Number : 562-285-1330
Fax Number : 562-263-3395
Provider Business Practice Location Address
First Line : 3633 E BROADWAY
Second Line :
City : LONG BEACH
State : CA
Zip : 90803-6035
Country : US
Telephone Number : 562-419-5663
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2007
Last Update Date : 04/25/2025

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