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NPI Code Detail

MEDICARE: SUSANYELES Y CHAVEZ

MEDICARE: SUSANYELES Y CHAVEZ
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
1225400000XRehabilitation PractitionerCA

General Provider Information

NPI Number : 1558099903
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSANYELES Y CHAVEZ
Provider Business Mailing Address
First Line : 709 5TH AVE
Second Line :
City : SAN RAFAEL
State : CA
Zip : 94901-3202
Country : US
Telephone Number : 510-221-7160
Fax Number :
Provider Business Practice Location Address
First Line : 709 5TH AVE
Second Line :
City : SAN RAFAEL
State : CA
Zip : 94901-3202
Country : US
Telephone Number : 510-221-7160
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2022
Last Update Date : 12/12/2025

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Directions to “ SUSANYELES Y CHAVEZ ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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