Provider Demographics
NPI:1184255903
Name:LEUNG, SUSAN (RD)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:LEUNG
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:
Other - Last Name:VOLKAMER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RD
Mailing Address - Street 1:7007 BROADWAY TER
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-1925
Mailing Address - Country:US
Mailing Address - Phone:925-580-5513
Mailing Address - Fax:
Practice Address - Street 1:3012 SUMMIT ST STE 2615
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3480
Practice Address - Country:US
Practice Address - Phone:510-869-6740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-30
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered