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Individual

LUCILLE MARY SUFFERN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
B.S, CPHT, CPT1

Contact information

Practice address
38256 MEMBERS CLUB DR, MURRIETA, CA 92563-5859
(714) 420-4326
Mailing address
38256 MEMBERS CLUB DR, MURRIETA, CA 92563-5859
(714) 420-4326

Taxonomy

Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
TCH16544
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
636053
NATIONAL CENTER FOR COMPETENCY TESTING
CA
01
CPT33756
CERTIFIED PHLEBOTOMIST DEPARTMENT OF PUBLIC HEALTH
CA
01
TCH16544
PHARMACY TECH LICENSE
CA
Enumeration date
01/23/2007
Last updated
06/17/2011
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