Provider Demographics
NPI:1083481857
Name:BILLINGTON, SUSANNA COLE (PT)
Entity Type:Individual
Prefix:
First Name:SUSANNA
Middle Name:COLE
Last Name:BILLINGTON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:SUSANNA
Other - Middle Name:MABEL
Other - Last Name:COLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:802 E BUCKHILL RD
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-0702
Mailing Address - Country:US
Mailing Address - Phone:612-239-8545
Mailing Address - Fax:
Practice Address - Street 1:MARQUIS SHASTA POST ACUTE REHAB
Practice Address - Street 2:3550 CHURN CREEK RD
Practice Address - City:REDDDING
Practice Address - State:CA
Practice Address - Zip Code:96002
Practice Address - Country:US
Practice Address - Phone:530-222-3630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35090208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation