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General NPI Number Information
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NPI Number | 1962601948
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Entity Type | Individual
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Provider Name | SUSAN ASHLEY CRISP NP-C
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Gender | Female
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Dates
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Enumeration Date | 07/11/2007
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | 195 PAGE MILL RD STE 103
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City | PALO ALTO
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State | CA
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Zip | 94306-2073
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Country | US
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Telephone | 888-731-8994
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Fax | 861-833-7751
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Provider Business Mailing Address
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Address Line | 14355 MIRANDA WAY
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City | LOS ALTOS HILLS
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State | CA
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Zip | 94022-2032
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Country | US
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Telephone | 888-731-8994
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Fax | 861-833-7751
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN135490
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | RN135490
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN135490
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License Number State | GA
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