Healthcare Provider Details

I. General information

NPI: 1992001184
Provider Name (Legal Business Name): SUSAN MCLAUGHLIN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2011
Last Update Date: 02/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1798 BAY RD STE A
EAST PALO ALTO CA
94303-5312
US

IV. Provider business mailing address

1798 BAY RD STE A
EAST PALO ALTO CA
94303-5312
US

V. Phone/Fax

Practice location:
  • Phone: 650-330-7491
  • Fax: 650-321-1156
Mailing address:
  • Phone: 650-330-7491
  • Fax: 650-321-1156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number339652
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: