Provider Demographics
NPI:1760873152
Name:SANZ, SUSAN (BSW,MSW, ASW)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:SANZ
Suffix:
Gender:F
Credentials:BSW,MSW, ASW
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:
Other - Last Name:SANZ-VAZQUEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BSW,MSW, ASW
Mailing Address - Street 1:8376 HERCULES ST
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-2902
Mailing Address - Country:US
Mailing Address - Phone:619-463-1378
Mailing Address - Fax:
Practice Address - Street 1:8376 HERCULES ST
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-2902
Practice Address - Country:US
Practice Address - Phone:619-463-1378
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-07
Last Update Date:2015-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health