Healthcare Provider Details

I. General information

NPI: 1699359042
Provider Name (Legal Business Name): BRIANA MARIE SUAREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRIANA MARIE LUNA

II. Dates (important events)

Enumeration Date: 05/11/2021
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

388 E YOSEMITE AVE STE 100
MERCED CA
95340-8219
US

IV. Provider business mailing address

388 E YOSEMITE AVE STE 100
MERCED CA
95340-8219
US

V. Phone/Fax

Practice location:
  • Phone: 209-722-7801
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA59683
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: