Provider Demographics
NPI:1386832798
Name:PALOMINO, SUSANA (RN)
Entity Type:Individual
Prefix:
First Name:SUSANA
Middle Name:
Last Name:PALOMINO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18225 HALE AVE
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-3547
Mailing Address - Country:US
Mailing Address - Phone:408-465-8280
Mailing Address - Fax:408-465-8281
Practice Address - Street 1:18217 HALE AVE
Practice Address - Street 2:PSYNERGY - MORGAN HILL
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-3550
Practice Address - Country:US
Practice Address - Phone:408-465-8280
Practice Address - Fax:408-465-8281
Is Sole Proprietor?:No
Enumeration Date:2007-10-10
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA549065163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse