Provider Demographics
NPI:1265260897
Name:OUSEY, SUZANNE (REGISTERED DIETITIAN)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:OUSEY
Suffix:
Gender:F
Credentials:REGISTERED DIETITIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 CREST DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95127-1606
Mailing Address - Country:US
Mailing Address - Phone:408-663-0070
Mailing Address - Fax:
Practice Address - Street 1:325 CREST DR
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95127-1606
Practice Address - Country:US
Practice Address - Phone:408-663-0070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-24
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA708602133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered