Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PSY25336 | CA |
Y | 103T00000X | Psychologist | PSY25336 | CA |
NPI | 1003829128 |
---|---|
Provider Name | Suzanne Lenz |
First Address | Redondo Beach, CA 90277-4373 |
Second Address | Torrance, CA 90505-6080 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2006 |
Last Update Date | 06/01/2021 |