Healthcare Provider Details

I. General information

NPI: 1902721343
Provider Name (Legal Business Name): SUSAN SIX RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3513 ARROYO AVE
DAVIS CA
95618-7102
US

IV. Provider business mailing address

3513 ARROYO AVE
DAVIS CA
95618-7102
US

V. Phone/Fax

Practice location:
  • Phone: 530-220-4639
  • Fax:
Mailing address:
  • Phone: 530-220-4639
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number445621
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: