Provider Demographics
NPI:1730385022
Name:FIGUEROA, SUSAN E (PHN, MSN,PSYD)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:E
Last Name:FIGUEROA
Suffix:
Gender:F
Credentials:PHN, MSN,PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 GEORGIA ST
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94590-6005
Mailing Address - Country:US
Mailing Address - Phone:707-563-0157
Mailing Address - Fax:
Practice Address - Street 1:4113 FALL CREEK CT
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94534-6637
Practice Address - Country:US
Practice Address - Phone:707-563-0157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-22
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA558165163W00000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health