Provider Demographics
NPI:1770833899
Name:O'CONNOR, SUSAN M (NP)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:M
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:MCMORROW
Other - Last Name:OGG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1975 4TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-2351
Mailing Address - Country:US
Mailing Address - Phone:415-353-1247
Mailing Address - Fax:415-353-1202
Practice Address - Street 1:1975 4TH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-2351
Practice Address - Country:US
Practice Address - Phone:415-353-1247
Practice Address - Fax:415-353-1202
Is Sole Proprietor?:No
Enumeration Date:2012-09-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX810237363L00000X
CA95001906363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner