Provider Demographics
NPI:1457413122
Name:DEMSEY, SUSAN AMARU (MS, CGC)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:AMARU
Last Name:DEMSEY
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4837 OCANA AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90713-2336
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:562-657-4408
Practice Address - Street 1:9449 IMPERIAL HWY
Practice Address - Street 2:SUITE 432 (GENETICS-OB)
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90242-2814
Practice Address - Country:US
Practice Address - Phone:562-657-3030
Practice Address - Fax:562-657-4408
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
170300000X
CAGC000121170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS