Provider Demographics
NPI:1427011246
Name:HAWSON, SUZANNE TAN (PT)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:TAN
Last Name:HAWSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:SUZANNE CARR
Other - Middle Name:TAN
Other - Last Name:HAWSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:23735 DEL MONTE DR
Mailing Address - Street 2:UNIT 170
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-3376
Mailing Address - Country:US
Mailing Address - Phone:818-261-8511
Mailing Address - Fax:
Practice Address - Street 1:2750 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:LA CRESCENTA
Practice Address - State:CA
Practice Address - Zip Code:91214-3517
Practice Address - Country:US
Practice Address - Phone:818-261-8511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT27951225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist