Provider Demographics
NPI:1821231580
Name:DELSARTO, SUZANNE (RN, PHN)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:
Last Name:DELSARTO
Suffix:
Gender:F
Credentials:RN, PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 216
Mailing Address - Street 2:140 NORTH FOREST HILL STREET
Mailing Address - City:COLFAX
Mailing Address - State:CA
Mailing Address - Zip Code:95716-0216
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1600 9TH ST
Practice Address - Street 2:MS-3-8, RM 330
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95814-6414
Practice Address - Country:US
Practice Address - Phone:916-654-1605
Practice Address - Fax:916-654-3255
Is Sole Proprietor?:No
Enumeration Date:2009-04-10
Last Update Date:2009-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA325113163WA2000X, 163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health