Provider Demographics
NPI:1235377342
Name:JONES, SUZANA (PHD)
Entity Type:Individual
Prefix:DR
First Name:SUZANA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18375 VENTURA BLVD
Mailing Address - Street 2:SUITE 712
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-4218
Mailing Address - Country:US
Mailing Address - Phone:661-373-4129
Mailing Address - Fax:
Practice Address - Street 1:18375 VENTURA BLVD
Practice Address - Street 2:SUITE 712
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-4218
Practice Address - Country:US
Practice Address - Phone:661-373-4129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-27
Last Update Date:2017-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY24566103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical