person
Susana Judith Praver, PAC
Medical Physician Assistant in Oakland, California
NPI 1255434452

Susana Judith Praver is a Medical Physician Assistant based in Oakland, CA and is specialized in Medical. Susana Judith Praver practices in Oakland, CA and has the professional credentials of PAC. The NPI Number for Susana Judith Praver is 1255434452 and holds a License No. PA10842 (California).

The current practice location address for Susana Judith Praver is 3451 E 12Th St, Oakland, CA and can be reached out via phone at 510-535-3317 and via fax at 510-535-4248.

Location: 3451 E 12Th St, Oakland, CA, 94601-2322
person
Provider Profile Details
NPI Number
1255434452
Provider Name
Susana Judith Praver
Credential
PAC
Provider Entity Type
Individual
Gender
Female
Address
3451 E 12Th St, Oakland, CA, 94601-2322
Phone Number
510-535-3317
Fax Number
510-535-4248
Provider Enumeration Date
09/06/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
HAP72021F 01 CA FPACT
FHC71021F 05 CA
55-1975 01 CA FQHC MEDICARE PART A
ZZZ29799Z 01 CA FQHC MEDICARE PART B
institution
Provider Business Practice Location Address Details
Address
3451 E 12Th St
City
State
Zip
94601
Phone Number
510-535-3317
Fax Number
510-535-4248
person
Provider Business Mailing Address Details
Address
3451 E 12Th St
City
State
Zip
94601
Phone Number
510-535-3317
Fax Number
510-535-4248
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
PA10842 (California)
Definition
Definition to come...
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