MEDICARE: MRS. ANNA SUDIT

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
1	103TS0200X	School Psychologist	250155927	CA

General Provider Information

NPI Number	:	1760333231
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANNA SUDIT

Provider Business Mailing Address
First Line	:	PO BOX 18016
Second Line	:
City	:	IRVINE
State	:	CA
Zip	:	92623-8016
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4070 MISSION AVE
Second Line	:
City	:	OCEANSIDE
State	:	CA
Zip	:	92057-6402
Country	:	US
Telephone Number	:	442-262-3249
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2026
Last Update Date	:	02/09/2026

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