Provider Demographics
NPI:1225747678
Name:SUESS, ALYSSIA JOAN (CNM)
Entity Type:Individual
Prefix:
First Name:ALYSSIA
Middle Name:JOAN
Last Name:SUESS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:ALYSSIA
Other - Middle Name:JOAN
Other - Last Name:LANFRANCHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:530 CONNIE ST
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:CA
Mailing Address - Zip Code:95240-3902
Mailing Address - Country:US
Mailing Address - Phone:732-259-0955
Mailing Address - Fax:
Practice Address - Street 1:4601 DALE RD
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95356-9718
Practice Address - Country:US
Practice Address - Phone:209-735-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-15
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA236331367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife