| Doctor Name: | MS. SUSAN CALLIE WIGHT |
| NPI Number: | 1043306707 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | RN 262603 |
| Business Practice Address: | 16111 Plummer St Oopw Sepulveda, CA - 913432036 |
| Business Phone Number: | 8188959555 |
| Business Fax Number: | 8188959453 |
| Mailing Address: | 16111 Plummer St, Oopw SEPULVEDA |
| State: | CA |
| Postal Code: | 913432036 |
| Phone Number: | 8188959555 |
| Fax Number: | 8188959453 |
| NPI Enumeration Date: | 10/04/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0808X |
| License Number: | RN 262603 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |