Provider Demographics
NPI:1174616445
Name:LORENZ, SUZANNE (LCSW)
Entity type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:
Last Name:LORENZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7510 SHORELINE DR
Mailing Address - Street 2:SUITE A-6
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95219-5495
Mailing Address - Country:US
Mailing Address - Phone:209-957-4222
Mailing Address - Fax:290-957-4222
Practice Address - Street 1:7510 SHORELINE DR
Practice Address - Street 2:SUITE A-6
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95219-5495
Practice Address - Country:US
Practice Address - Phone:209-957-4222
Practice Address - Fax:290-957-4222
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS192521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical