Provider Demographics
NPI:1124315288
Name:BECKER, SUZANNE MARIE (PT, DPT, SCS)
Entity type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:MARIE
Last Name:BECKER
Suffix:
Gender:F
Credentials:PT, DPT, SCS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:10900 WARNER AVE
Mailing Address - Street 2:#111
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-3846
Mailing Address - Country:US
Mailing Address - Phone:714-907-9090
Mailing Address - Fax:714-964-8806
Practice Address - Street 1:10900 WARNER AVE
Practice Address - Street 2:#111
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-3846
Practice Address - Country:US
Practice Address - Phone:714-907-9090
Practice Address - Fax:714-964-8806
Is Sole Proprietor?:No
Enumeration Date:2011-07-08
Last Update Date:2017-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38015225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist