Provider Demographics
NPI:1588855357
Name:ACHEN, SUSAN (DNP, MPH, WHNP-BC)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:
Last Name:ACHEN
Suffix:
Gender:F
Credentials:DNP, MPH, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5555 RESERVOIR DR STE 207
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92120-5149
Mailing Address - Country:US
Mailing Address - Phone:619-255-1754
Mailing Address - Fax:
Practice Address - Street 1:5555 RESERVOIR DR STE 207
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92120-5149
Practice Address - Country:US
Practice Address - Phone:619-255-1754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP 12568363LW0102X, 363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health