Healthcare Provider Details

I. General information

NPI: 1184878654
Provider Name (Legal Business Name): SUSAN MARY KARPLUS N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUSAN MARY GRIMES N.P.

II. Dates (important events)

Enumeration Date: 11/11/2008
Last Update Date: 04/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20400 LAKE CHABOT RD SUITE 102
CASTRO VALLEY CA
94546-5311
US

IV. Provider business mailing address

2345 COUNTRY HILLS DR
ANTIOCH CA
94509-7319
US

V. Phone/Fax

Practice location:
  • Phone: 510-247-9227
  • Fax: 510-247-9241
Mailing address:
  • Phone: 925-418-0279
  • Fax: 925-978-0991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number385018
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP 18840
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: