Provider Demographics
NPI:1740370055
Name:THOMAS, SUZANNE L (MS, RN, CNS)
Entity type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:L
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MS, RN, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:916 W BURBANK BLVD UNIT C141
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91506-1400
Mailing Address - Country:US
Mailing Address - Phone:424-296-3707
Mailing Address - Fax:
Practice Address - Street 1:12021 WILMINGTON AVE BLDG 11
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90059-3019
Practice Address - Country:US
Practice Address - Phone:424-296-3707
Practice Address - Fax:424-338-8984
Is Sole Proprietor?:No
Enumeration Date:2006-10-15
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA472367163W00000X, 163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163W00000XNursing Service ProvidersRegistered Nurse