Basic Information
| Provider Information | |||||||||
| NPI: | 1891857694 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MENZIE | ||||||||
| FirstName: | SUSAN | ||||||||
| MiddleName: | LYNNE | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | RN BSN MS | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 592 RIO LINDO AVE | ||||||||
| Address2: | |||||||||
| City: | CHICO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 959261817 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5308912775 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 592 RIO LINDO AVE | ||||||||
| Address2: | |||||||||
| City: | CHICO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 959261817 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5308912775 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/15/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN244537 | CA | X | Nursing Service Providers | Registered Nurse | 163WP0807X | LIC244537 | CA | X | Nursing Service Providers | Registered Nurse | Psych/Mental Health, Child & Adolescent | 163WP0808X | RN244537 | CA | X | Nursing Service Providers | Registered Nurse | Psych/Mental Health | 163WP0809X | RN244537 | CA | X | Nursing Service Providers | Registered Nurse | Psych/Mental Health, Adult |
No ID Information.