Individual
SUSAN DORAIRAJ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
5321 VIA MARISOL, LOS ANGELES, CA 90042-4883
(323) 478-8200
Mailing address
1311 N. SAN FERNANDO BLVD., BURBANK, CA 91504
(818) 843-9900
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95006080
CA
Other
Enumeration date
12/01/2017
Last updated
01/16/2024
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