Provider Demographics
NPI:1164979175
Name:LLAMADO, SUZANNE (RN PHN MSN)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:LLAMADO
Suffix:
Gender:F
Credentials:RN PHN MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3725 WESTWIND BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95403-9081
Mailing Address - Country:US
Mailing Address - Phone:707-565-5733
Mailing Address - Fax:707-565-5739
Practice Address - Street 1:3725 WESTWIND BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-9081
Practice Address - Country:US
Practice Address - Phone:707-565-5733
Practice Address - Fax:707-565-5739
Is Sole Proprietor?:No
Enumeration Date:2016-09-07
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA296814163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse