Provider Demographics
NPI:1750826962
Name:MAGORNO, SUSAN MARIE (DNP, APRN, PMHNP-BC)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:MARIE
Last Name:MAGORNO
Suffix:
Gender:F
Credentials:DNP, APRN, PMHNP-BC
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Mailing Address - Street 1:8235 SANTA MONICA BLVD STE 302
Mailing Address - Street 2:
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90046-5969
Mailing Address - Country:US
Mailing Address - Phone:310-892-4284
Mailing Address - Fax:323-366-2966
Practice Address - Street 1:21535 HAWTHORNE BLVD STE 200
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-6612
Practice Address - Country:US
Practice Address - Phone:424-284-2440
Practice Address - Fax:415-296-5299
Is Sole Proprietor?:No
Enumeration Date:2016-12-23
Last Update Date:2021-08-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA95011949363LP0808X
HIAPRN-2536363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health