Individual
MS. ANCA SUSAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14558 SYLVAN ST, VAN NUYS, CA 91411-2324
(818) 787-4151
(818) 787-2840
Mailing address
4170 TUJUNGA AVE APT 3, STUDIO CITY, CA 91604-3083
(818) 506-6590
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CAS REGST. # 5108
CA
Other
Enumeration date
04/23/2007
Last updated
07/08/2007
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