MEDICARE: SUSAN CASPAR RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WS0200X	School Registered Nurse	495831	CA

General Provider Information

NPI Number	:	1235072729
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN CASPAR RN

Provider Business Mailing Address
First Line	:	871 LOS MOLINOS WAY
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95864-5251
Country	:	US
Telephone Number	:	916-214-8033
Fax Number	:

Provider Business Practice Location Address
First Line	:	1931 ARENA BLVD
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95834-3721
Country	:	US
Telephone Number	:	916-214-8033
Fax Number	:	916-302-4043

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2026
Last Update Date	:	04/10/2026

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