MS. SUSANA MCKEOUGH (NPI# 1134527963) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134527963 |
| Entity Type | Individual |
| Full Name | MS. SUSANA MCKEOUGH |
| Credential | RN, FNP |
| Practice Address |
179 Acacia Avenue Room 100 Dominican University Student Health Center San Rafael CA 94901 |
| Mailing Address |
50 Acacia Ave. Student Health Center - Dominican University San Rafael CA 94901 |
| Practice Telephone | 4154853208 |
| Practice Fax Number | 4154583755 |
| Mailing Telephone | 4154853208 |
| Mailing Fax Number | 4154583755 |
| Enumeration Date | 2014-12-10 |
| Last Update Date | 2014-12-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 7901 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
179 ACACIA AVENUE ROOM 100 DOMINICAN UNIVERSITY STUDENT HEALTH CENTER |
| City | SAN RAFAEL |
| State | CA |
| Zip Code | 94901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780207134 | Marianne Haissman Stefancic | Marriage & Family Therapist | 409 Forbes Ave., San Rafael, CA 94901 | 2020-05-20 |
| 1093292765 | Marin Community Clinic | Clinic/Center | 411 4th Strteet, Suite A, San Rafael, CA 94901 | 2018-07-25 |
| 1275052516 | Laura Ellen Silverstein | Marriage & Family Therapist | 600 Fifth Avenue, San Rafael, CA 94901 | 2017-09-19 |
| 1689101107 | Marin Family Recovery | Clinic/Center | 1209 Third St. Ste 4, San Rafael, CA 94901 | 2017-05-15 |
| 1376070011 | Tencia Beavers-sanchez | Counselor | 710 C Street Suite#8, Marin Outpatient&recoveryservices, Sanrafael, CA 94901 | 2017-05-12 |
| 1326584905 | Jamie Waterman | Emergency Medical Technician, Basic | 675 Sir Francis Drake Blvd, Kentfield, CA 94901 | 2017-01-06 |
| 1295270676 | Stephen Marks | Counselor | 900 Fifth Avenue, Suite 150, ; San Rafael, CA 94901 | 2016-12-21 |
| 1497299812 | Vesna Sturman | Psychologist | 712 D St Ste L, San Rafael, CA 94901 | 2016-12-05 |
| 1063955771 | Carol Dutton Hollenberg | Behavior Technician | 503 D St., San Rafael, CA 94901 | 2016-11-29 |
| 1083069447 | Bay Area Community Resources | Community/Behavioral Health | 103 Shoreline Parkway, San Rafael, CA 94901 | 2016-05-04 |
| Find all providers in zip 94901 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720238918 | Keri Schwartz | Nurse Practitioner | 1177 E.francisco Blvd. Suite B, San Rafael, CA 94901 | 2008-09-24 |
| 1033223755 | Marne Anne Burgess | Nurse Practitioner | 10 N San Pedro Rd, Suite 1020, San Rafael, CA 94903-4178 | 2006-08-19 |
| 1831740422 | Natalie Marie Vano | Nurse Practitioner | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2019-09-25 |
| 1588137434 | Amanda Adams | Nurse Practitioner | 718 4th St, San Rafael, CA 94901-3213 | 2019-01-03 |
| 1992990782 | Shirley Elaine Hannah | Nurse Practitioner | 25 Mitchell Blvd, San Rafael, CA 94903-2007 | 2007-09-13 |
| 1285762609 | Kerry Patricia Murphy | Nurse Practitioner | 3270 Kerner Blvd, Suite A, San Rafael, CA 94901-4840 | 2007-02-28 |
| 1689603490 | Gina Noelle Cloney | Nurse Practitioner | 99 Montecillo Rd, San Rafael, CA 94903-3308 | 2006-07-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114528817 | Gemekia Latrisha Morales | Nurse Practitioner | 1800 N. California, Stockton, CA 95952 | 2020-11-08 |
| 1447851324 | Anna Patricia Torres | Nurse Practitioner | 1158 Santa Lucia Dr, Pittsburg, CA 94565-7615 | 2020-11-05 |
| 1447851647 | Melanie Ganotisi | Nurse Practitioner | 11541 Blucher Ave Unit 125, Granada Hills, CA 91344-4362 | 2020-11-04 |
| 1659971729 | Raquel Y Mccarthy | Nurse Practitioner | 334 Via Vera Cruz Ste 257, San Marcos, CA 92078-2643 | 2020-10-28 |
| 1689274607 | Aleksandra Zaitseva | Nurse Practitioner | 6850 Sepulveda Blvd Ste 215, Van Nuys, CA 91405-4450 | 2020-10-28 |
| 1215537543 | Gereine Mae Condino Datan | Nurse Practitioner | 500 W 190 St, Gardena, CA 90248 | 2020-10-27 |
| 1861092355 | Vilma Estrada | Nurse Practitioner | 37945 28th St E, Palmdale, CA 93550-5521 | 2020-10-26 |
| 1871192492 | Folashade Jayeoba | Nurse Practitioner | 7453 Tucson Ln, Fontana, CA 92336-0712 | 2020-10-23 |
| 1467051391 | Careforyou LLC | Nurse Practitioner | 806 14th St, Modesto, CA 95354-1023 | 2020-10-21 |
| 1427657550 | Adriana Sarah Pettross | Nurse Practitioner | 35286 Vista De Todo, Capistrano Beach, CA 92624-1847 | 2020-10-20 |
| Find all providers with the same taxonomy | ||||
| City | SAN RAFAEL |
| Zip Code | 94901 |
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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.