Basic Information
| Provider Information | |||||||||
| NPI: | 1134181142 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DONG-MATSUDA | ||||||||
| FirstName: | SUZIE | ||||||||
| MiddleName: | XUYEN | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 17771 PLUM TREE LN | ||||||||
| Address2: | |||||||||
| City: | YORBA LINDA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928865124 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7148967591 | ||||||||
| FaxNumber: | 7148967408 | ||||||||
| Practice Location | |||||||||
| Address1: | 405 W 5TH ST | ||||||||
| Address2: | STE 550 | ||||||||
| City: | SANTA ANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927014519 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7148344707 | ||||||||
| FaxNumber: | 7148345939 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/05/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 20779 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.