Wallace, Susan O'Brien

Wallace, Susan O'Brien is an individual health care provider with primary practice located at 1454 E 2Nd St , San Bernardino CA 92408-0118. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Wallace, Susan O'Brien can be contacted via phone (909) 382-7100.

Contact Information

Primary practice address
1454 E 2Nd St San Bernardino CA 92408-0118
Phone: (909) 382-7100
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY27744 California

Profile Details

NPI number 1295907392
LBN Legal business name Wallace, Susan O'Brien
Credentials PSY. D.
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2008
Last updated Feb 21st, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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