Provider Demographics
NPI:1801217260
Name:SPITZER, SUSAN LANELL (PHD, OTR/L)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:LANELL
Last Name:SPITZER
Suffix:
Gender:F
Credentials:PHD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:572 EAST GREEN STREET
Mailing Address - Street 2:SUITE 204
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-2077
Mailing Address - Country:US
Mailing Address - Phone:626-795-7817
Mailing Address - Fax:626-795-7392
Practice Address - Street 1:572 EAST GREEN STREET
Practice Address - Street 2:SUITE 204
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2077
Practice Address - Country:US
Practice Address - Phone:626-795-7817
Practice Address - Fax:626-795-7392
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-02
Last Update Date:2014-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT58225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist