Provider Demographics
NPI:1609012012
Name:LOWE, SUSAN D (RN,NP)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:D
Last Name:LOWE
Suffix:
Gender:F
Credentials:RN,NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20751 AQUATIC LN
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92646-6602
Mailing Address - Country:US
Mailing Address - Phone:714-962-9625
Mailing Address - Fax:
Practice Address - Street 1:18432 GRIDLEY RD
Practice Address - Street 2:
Practice Address - City:ARTESIA
Practice Address - State:CA
Practice Address - Zip Code:90701-5404
Practice Address - Country:US
Practice Address - Phone:562-860-2479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-07
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA185217163WP0808X
CA11215363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health