Susan Derby

NPI #1689120545 in Venice, California

Provider Information

NPI Number: 1689120545
Entity Type: Individual
Name: Susan Derby
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Aug 31, 2016
Last Updated: Mar 27, 2017

Practice Location

Address: 204 HAMPTON DR
City: Venice
State: California
ZIP Code: 90291-2623
Phone: (310) 396-6468

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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