Provider Demographics
NPI:1740604727
Name:VIDEON, SUZANNE (RN)
Entity Type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:
Last Name:VIDEON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7392 VOLCLAY DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92119-1605
Mailing Address - Country:US
Mailing Address - Phone:615-969-8383
Mailing Address - Fax:
Practice Address - Street 1:34022 TEMECULA CREEK RD
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-5646
Practice Address - Country:US
Practice Address - Phone:615-969-8383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-11
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0000072300163W00000X
TN0000072300163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse