Healthcare Provider Details

I. General information

NPI: 1831113075
Provider Name (Legal Business Name): SUSAN J REES RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9261 FOLSOM BLVD SUITE 300
SACRAMENTO CA
95826-2561
US

IV. Provider business mailing address

1431 Q ST APT. # 323
SACRAMENTO CA
95814-6653
US

V. Phone/Fax

Practice location:
  • Phone: 916-854-4552
  • Fax: 916-854-4556
Mailing address:
  • Phone: 978-505-7099
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number675038
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: