Provider Demographics
NPI:1689864001
Name:CHAPIN, SUZANNE ANNETTE (NP)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:ANNETTE
Last Name:CHAPIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24372 VANOWEN ST STE 101
Mailing Address - Street 2:
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91307-2800
Mailing Address - Country:US
Mailing Address - Phone:818-963-8188
Mailing Address - Fax:
Practice Address - Street 1:24372 VANOWEN ST STE 101
Practice Address - Street 2:
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-2800
Practice Address - Country:US
Practice Address - Phone:818-963-8188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANPF4584363LP0200X
CA4584363LF0000X
CA388185363LP0200X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMC3379600OtherDEA