MRS. SUSAN I. IVANCIC (NPI# 1083751192) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083751192 |
| Entity Type | Individual |
| Full Name | MRS. SUSAN I. IVANCIC |
| Credential | RN, BSN, CDE, SNIV |
| Practice Address |
99 Montecillo Rd San Rafael CA 94903-3308 |
| Practice Telephone | 4154442575 |
| Practice Fax Number | 4154444622 |
| Mailing Telephone | 4154442575 |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WC0400X |
Registered Nurse Specialization: Case Management |
172329 | CA | Nursing Service Providers |
| Street Address |
99 MONTECILLO RD |
| City | SAN RAFAEL |
| State | CA |
| Zip Code | 94903-3308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174528889 | Jeffry D Cardneau | Surgery | 99 Montecillo Rd, Mob 1, 2nd Floor, Department of Surgery, San Rafael, CA 94903-3308 | 2005-06-17 |
| 1225645468 | Lauren Freudman | Occupational Therapist | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2020-09-30 |
| 1285254037 | Omar Ahmed | Pharmacist | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2020-04-22 |
| 1447887229 | Meka Angela Parks | Registered Nurse | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2020-03-24 |
| 1710519202 | Mahsa Khorramdin | Pharmacist | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2020-02-12 |
| 1568001071 | Jessica Tan | Pharmacist | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2019-12-31 |
| 1720626211 | Ava May Mahan | Pharmacist | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2019-12-15 |
| 1437797271 | Alicia Pontecorvo | Dietitian, Registered | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2019-12-11 |
| 1437795499 | Shirley Liu | Pharmacist | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2019-11-25 |
| 1831740422 | Natalie Marie Vano | Nurse Practitioner | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2019-09-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467089524 | Christopher Sazo | Counselor | 1 St. Vincents Drive, San Rafael, CA 94903 | 2020-03-26 |
| 1134769482 | Katherine Sieger | Music Therapist | 400 Civic Center Dr. #300, San Rafael, CA 94903 | 2020-01-14 |
| 1679064836 | California In Home Care & Registry, Inc | In Home Supportive Care | 14b Mitchell Blvd, Suite B, San Rafael, CA 94903 | 2018-05-23 |
| 1922557586 | Helen Elizabeth Shamis | Marriage & Family Therapist | 30 North San Pedro, Suite #265, Beyond Hunger, San Rafael, CA 94903 | 2016-09-23 |
| 1033572771 | Henry Colbert | Counselor | 1 St. St. Vincent Drive, San Rafael, CA 94903 | 2016-03-31 |
| 1659736924 | Robyn Bloom | Marriage & Family Therapist | 4 Joseph Court, San Rafael, CA 94903 | 2015-12-30 |
| 1851760565 | Cheryl Clementson | Substance Abuse Rehabilitation Facility | 301 Smith Ranch Road, San Rafael, CA 94903 | 2015-09-23 |
| 1588043731 | Chelsea Cooney | Counselor | 1 St. Vincent's Drive, San Rafael, CA 94903 | 2015-05-20 |
| 1083002315 | Kaiser Permanente | Psychiatric Unit | 111 Smith Ranch Road, Kaiser Permanente, San Rafael, CA 94903 | 2015-01-09 |
| 1366857856 | Travel Well Corporation | Preventive Medicine | 28 Mitchell Blvd, San Rafael, CA 94903 | 2014-06-24 |
| Find all providers in zip 94903 | ||||
| Taxonomy Code | 163WC0400X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Case Management |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336329473 | Wes Whalon | Registered Nurse | 899 Northgate Dr, Suite 100, San Rafael, CA 94903-3636 | 2007-11-06 |
| 1427343615 | Erica Sutherland | Registered Nurse | 16 Ritter St, San Rafael, CA 94901-3323 | 2011-06-15 |
| 1912187048 | Linda Maria Mariscal | Registered Nurse | 899 Northgate Dr, Suite 100, San Rafael, CA 94903-3636 | 2007-11-06 |
| 1346389665 | Pamela England | Registered Nurse | 99 Montecillo Rd, Mob 2, San Rafael, CA 94903-3308 | 2007-02-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780285031 | Yanhong Yuan | Registered Nurse | 2171 Junipero Serra Blvd Ste 600, Daly City, CA 94014-1990 | 2020-11-03 |
| 1760081988 | Christine J. Wilson | Registered Nurse | 15007 Hartland St, Van Nuys, CA 91405-3714 | 2020-10-19 |
| 1407466899 | Pamela Ann Engelke | Registered Nurse | 240 Nice Ln Apt 117, Newport Beach, CA 92663-2652 | 2020-07-31 |
| 1982220653 | Karen Elizabeth Mitchell | Registered Nurse | County of San Diego California Children's Services (ccs, 6991 Balboa Ave, (room 70), San Diego, CA 92111 | 2020-06-18 |
| 1932724689 | Deborah Ruth Toga | Registered Nurse | 587 Prospect Blvd, Pasadena, CA 91103-3235 | 2020-06-09 |
| 1750904066 | Emer Gaite | Registered Nurse | 1697 Greenyard Ct, Brentwood, CA 94513-5844 | 2020-05-20 |
| 1396367140 | Janice Ann Oliver | Registered Nurse | 4393 Date Ave, La Mesa, CA 91941-6412 | 2020-05-15 |
| 1083236863 | Rachel Materum | Registered Nurse | 2190 Holder Ln, Tracy, CA 95377-9575 | 2020-05-14 |
| 1154943926 | Susan Guajardo | Registered Nurse | 2695 Country Ln, Westlake Village, CA 91361-5534 | 2020-05-14 |
| 1336761329 | Nancy Davis | Registered Nurse | 307 Greenview Rd, Escondido, CA 92026-3932 | 2020-05-12 |
| Find all providers with the same taxonomy | ||||
| City | SAN RAFAEL |
| Zip Code | 94903 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.