Healthcare Provider Details

I. General information

NPI: 1154650216
Provider Name (Legal Business Name): SUZANNE SEGER CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2009
Last Update Date: 12/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 PARNASSUS AVE PLAZA LEVEL
SAN FRANCISCO CA
94143-2202
US

IV. Provider business mailing address

505 PARNASSUS AVE UNIVERSITY OF CALIFORNIA SAN FRANCISCO, BOX 0132
SAN FRANCISCO CA
94143-0132
US

V. Phone/Fax

Practice location:
  • Phone: 415-514-9399
  • Fax: 416-476-1811
Mailing address:
  • Phone: 415-514-9399
  • Fax: 416-476-1811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number651107
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: