Provider Demographics
NPI:1700505716
Name:ROMERO, SUSANA ELIZABETH
Entity Type:Individual
Prefix:MS
First Name:SUSANA
Middle Name:ELIZABETH
Last Name:ROMERO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2709 MEDIA CENTER DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90065-1700
Mailing Address - Country:US
Mailing Address - Phone:323-539-2810
Mailing Address - Fax:
Practice Address - Street 1:2420 1/2 E 4TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-4324
Practice Address - Country:US
Practice Address - Phone:323-490-9859
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant