Provider Demographics
NPI:1871027276
Name:HAN, SUSAN XIAOPING (NP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:XIAOPING
Last Name:HAN
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 1:5049 LYNBROOK CT
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-4256
Mailing Address - Country:US
Mailing Address - Phone:925-519-3904
Mailing Address - Fax:
Practice Address - Street 1:215 ABBIE ST
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-7343
Practice Address - Country:US
Practice Address - Phone:925-426-4290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-12
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11195363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily