Provider Demographics
NPI:1730213497
Name:SUZUKI, ALEJANDRA RUTH (MD)
Entity type:Individual
Prefix:DR
First Name:ALEJANDRA
Middle Name:RUTH
Last Name:SUZUKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 JENNER STE 210
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3844
Mailing Address - Country:US
Mailing Address - Phone:714-867-7037
Mailing Address - Fax:
Practice Address - Street 1:1 JENNER STE 210
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3844
Practice Address - Country:US
Practice Address - Phone:714-867-7037
Practice Address - Fax:714-252-7934
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA723292084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI18704Medicare UPIN
CAA72329Medicare ID - Type UnspecifiedPROVIDER ID NUMBER