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NPI Code Detail

MEDICARE: THYREAK SUGGS

MEDICARE: THYREAK SUGGS
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
1172V00000XCommunity Health Worker
2103K00000XBehavior Analyst

General Provider Information

NPI Number : 1518525328
Entity Type Code : Individual
Provider Name (Legal Business Name) : THYREAK SUGGS
Provider Business Mailing Address
First Line : 203 COVENTRY WAY
Second Line :
City : VALLEJO
State : CA
Zip : 94591-8110
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1116 LEGEND CIR
Second Line :
City : VALLEJO
State : CA
Zip : 94591-8679
Country : US
Telephone Number : 707-563-0157
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2019
Last Update Date : 11/03/2023

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Directions to “ THYREAK SUGGS ” Practice Location

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