Provider Demographics
NPI:1881098887
Name:PLETTNER, SUZZETTE LENORE (LMT)
Entity type:Individual
Prefix:MS
First Name:SUZZETTE
Middle Name:LENORE
Last Name:PLETTNER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MS
Other - First Name:SUSIE
Other - Middle Name:LENORE
Other - Last Name:PLETTNER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMT
Mailing Address - Street 1:3028 VANCOUVER AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92104-4833
Mailing Address - Country:US
Mailing Address - Phone:415-378-5086
Mailing Address - Fax:
Practice Address - Street 1:203 W F ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-6016
Practice Address - Country:US
Practice Address - Phone:619-471-3800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-20
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39004175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath