Basic Information
| Provider Information | |||||||||
| NPI: | 1235889528 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | YOUSSEF | ||||||||
| FirstName: | SUSAN | ||||||||
| MiddleName: | MAHMOUD | ||||||||
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| Credential: | M.S, CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 23731 DEL MONTE DR UNIT 175 | ||||||||
| Address2: | |||||||||
| City: | VALENCIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913553835 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8183192592 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 28245 AVENUE CROCKER STE 220 | ||||||||
| Address2: | |||||||||
| City: | VALENCIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913551201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6612547086 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/28/2022 | ||||||||
| LastUpdateDate: | 03/28/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/28/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 28071 | CA | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.