Individual
STEPHANIE M KUSSER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
1665 SCENIC AVE, COSTA MESA, CA 92626-1445
(310) 214-5722
(310) 793-3756
Mailing address
5901 E 7TH ST, LONG BEACH, CA 90822-5201
(562) 583-6086
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
564744
CA
363LG0600X
Gerontology Nurse Practitioner
Primary
18511
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3054
CNS LICENSE
CA
01
—
564744
RN LICENSE
CA
01
—
G1108185
NP CERTIFICAITON
CA
Enumeration date
02/11/2009
Last updated
08/23/2019
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