Provider Demographics
NPI:1093205486
Name:CORTEZ, SUZANNA JUANITA
Entity Type:Individual
Prefix:
First Name:SUZANNA
Middle Name:JUANITA
Last Name:CORTEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:935 W HEMLOCK ST
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93033-3357
Mailing Address - Country:US
Mailing Address - Phone:805-844-7227
Mailing Address - Fax:
Practice Address - Street 1:935 W HEMLOCK ST
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93033-3357
Practice Address - Country:US
Practice Address - Phone:805-844-7227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-11
Last Update Date:2018-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health