Provider Demographics
NPI:1992095053
Name:OCOPNICK, SUSAN (DC RN)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:
Last Name:OCOPNICK
Suffix:
Gender:F
Credentials:DC RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 GLENCREST DR
Mailing Address - Street 2:
Mailing Address - City:SOLANA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92075-1406
Mailing Address - Country:US
Mailing Address - Phone:858-350-9818
Mailing Address - Fax:858-350-9818
Practice Address - Street 1:311 GLENCREST DR
Practice Address - Street 2:
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-1406
Practice Address - Country:US
Practice Address - Phone:858-350-9818
Practice Address - Fax:858-350-9818
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-11
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15341111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor