SUSAN NYLEN (NPI# 1205823077) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205823077 |
| Entity Type | Individual |
| Full Name | SUSAN NYLEN |
| Credential | NFP |
| Practice Address |
1140 Norman Dr Suite 101 Manteca CA 95336-5900 |
| Practice Telephone | 2098257748 |
| Mailing Telephone | 2098257748 |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2008-02-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
CA | Allopathic & Osteopathic Physicians |
| Street Address |
1140 NORMAN DR SUITE 101 |
| City | MANTECA |
| State | CA |
| Zip Code | 95336-5900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992791180 | Anil K Sain | Internal Medicine | 1140 Norman Dr, Suite 1, Manteca, CA 95336-5900 | 2005-09-22 |
| 1821286089 | Craig Bobson North Street Family Practice | Family Medicine | 1140 Norman Dr, Suite 101, Manteca, CA 95336-5955 | 2007-10-11 |
| 1437179660 | Cassandra June Mccurdy | Nurse Practitioner | 1140 Norman Dr, Suite 103, Manteca, CA 95336-5900 | 2006-07-20 |
| 1497775902 | Rhonda M. Brazil | Nurse Practitioner | 1140 Norman Dr, Manteca, CA 95336-5900 | 2006-07-20 |
| 1679599070 | Maria Isabel Bacay | Internal Medicine | 1140 Norman Dr, Suite 103, Manteca, CA 95336-5900 | 2006-07-15 |
| 1629094032 | Bernard Songco Bacay | Internal Medicine | 1140 Norman Dr, Ste 103, Manteca, CA 95336-5900 | 2006-07-15 |
| 1760459416 | Bacay Aruiza Medical Associates Inc | Clinic/Center | 1140 Norman Dr, Suite 103, Manteca, CA 95336-5900 | 2006-03-01 |
| 1790772986 | Craig Bobson | Family Medicine | 1140 Norman Dr, Suite 101, Manteca, CA 95336-5900 | 2005-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225687676 | Kasside Sahagun-escalante | Behavior Technician | 402 Victory Ave, Manteca, CA 95336 | 2019-09-09 |
| 1295253797 | Adriana Pena | Counselor | 129 E.center Street Ste.3, Manteca, CA 95336 | 2017-09-05 |
| 1104352277 | Native Directions Inc. | Substance Abuse Rehabilitation Facility | 13505 Union Rd, Manteca, CA 95336 | 2017-05-10 |
| 1437508389 | Anna Gavin | Contractor | 1256 W. Lathrop Rd #376, Manteca, CA 95336 | 2016-06-10 |
| 1164826137 | Michael M. Catz, M.d., Inc | Anesthesiology | 1205 E. North Street, Manteca, CA 95336 | 2014-10-20 |
| 1033518923 | Leanne Louis | Community Health Worker | 129 E Center Street, #3, Manteca, CA 95336 | 2014-08-18 |
| 1255684122 | Kenneth S. Ching, Md., Inc | Anesthesiology | 1205 East North Street, Manteca, CA 95336 | 2012-10-17 |
| 1629323043 | Harpradeep Ratia | Dentist | 1332 E Yosemite Ave, Manteca, CA 95336 | 2012-07-23 |
| 1750643664 | Shelley Marie Kohl | Specialist/Technologist, Other | 425 E. Center St Suite 1, Manteca, CA 95336 | 2012-06-15 |
| 1932488038 | Valerie Diane Segura | Behavioral Analyst | 1882 Cherrywood Pl, Manteca, CA 95336 | 2011-08-08 |
| Find all providers in zip 95336 | ||||
| Taxonomy Code | 207QA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Addiction Medicine |
| A family medicine physician who specializes in the diagnosis and treatment of addictions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Family Physicians. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194332726 | True North Detox LLC | Family Medicine | 2413 Whitmore Ave, Clovis, CA 93619-9252 | 2020-09-28 |
| 1639717473 | Michael Stone Md Inc | Family Medicine | 1950 E 17th St Ste 101, Santa Ana, CA 92705-6852 | 2019-12-11 |
| 1720624497 | Marina Harbor Detox | Family Medicine | 289 Marina Blvd, San Francisco, CA 94123-1212 | 2019-11-18 |
| 1093363848 | Anthony Martin Ocana | Family Medicine | 13924 Marquesas Way Apt 1520, Marina Del Rey, CA 90292-6018 | 2019-08-26 |
| 1821640137 | L Snyder Incorporated | Family Medicine | 34052 La Plaza #101, Dana Point, CA 92629 | 2019-07-16 |
| 1720645328 | Creative Child and Family Services, Inc. | Family Medicine | 7049 Ohio River Dr, Eastvale, CA 91752 | 2019-05-20 |
| 1932666575 | Gold Country Health Initiative, LLC | Family Medicine | 820/830 State Highway 88, Jackson, CA 95642 | 2019-03-01 |
| 1629550660 | University of California Sfgh Medical Group | Family Medicine | 1001 Potrero Ave Rm 5h22, San Francisco, CA 94110-3518 | 2018-09-06 |
| 1952809592 | Sunrise Health & Wellness Center, LLC | Family Medicine | 10089 Folsom Blvd. Suites A & C, Rancho Cordova, CA 95670-1935 | 2018-01-29 |
| 1487166120 | Good Samaritan Shelter | Family Medicine | 412 East Tunnell Street, Santa Maria, CA 93454 | 2017-11-03 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on SUSAN NYLEN.
| 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.