Individual provider · Type 1 NPI

Susan Derby

Student in an Organized Health Care Education/Training Program · Venice, CA

NPI number 1689120545 Active

Practice location

204 Hampton Dr
Venice, CA 90291-2623

Call (310) 396-6468 Map

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1689120545

Susan Derby's National Provider Identifier is 1689120545, issued on Aug 31, 2016. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Venice, CA. The record was last updated on Mar 27, 2017.