Provider Demographics
NPI:1629259783
Name:DERANLEAU-SILVEIRA, SUSAN MARIE (RN)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:MARIE
Last Name:DERANLEAU-SILVEIRA
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 1:80 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SAN MARTIN
Mailing Address - State:CA
Mailing Address - Zip Code:95046-9504
Mailing Address - Country:US
Mailing Address - Phone:408-686-8733
Mailing Address - Fax:
Practice Address - Street 1:80 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:SAN MARTIN
Practice Address - State:CA
Practice Address - Zip Code:95046-9504
Practice Address - Country:US
Practice Address - Phone:408-686-8733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-16
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA264172163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management