Suzanne Dietz, PNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

264132 Issued in CA

Practice address

2200 Tydd St
Eureka, CA 95501-1284

Phone

(707) 269-7051

Fax

(707) 269-7054

NPI assigned

Jun 13, 2005

Last updated

Oct 21, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Interoperability endpoints

• Direct secure messaging: sdietz1647949@oc.providencedirect.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Eureka Pediatrics Medical Practice

  dba Eureka Pediatrics McKinleyville Office

  • Pediatric Adolescent Medicine Physician
  • McKinleyville, CA
  • NPI 1669775730
  NPD (past)
• Eureka Pediatrics Medical Practice

  • Pediatric Adolescent Medicine Physician
  • Eureka, CA
  • NPI 1881706380
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1033113535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 9TH ST STE 203",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955216249",
            "telephone_number": "707-269-7051",
            "fax_number": "707-269-7054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 TYDD ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955011284",
            "telephone_number": "707-269-7051",
            "fax_number": "707-269-7054"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2800 Harris St",
            "address_purpose": "LOCATION",
            "city": "Eureka",
            "state": "CA",
            "postal_code": "955034809",
            "country_code": "US",
            "telephone_number": "707-445-8416",
            "fax_number": "707-445-4182",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIETZ",
        "first_name": "SUZANNE",
        "name_prefix": "Ms.",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-13",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "264132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sdietz1647949@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "2280 Harrison Ave Ste B",
            "city": "Eureka",
            "state": "CA",
            "country_code": "US",
            "postal_code": "955013200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Nurse Practitioner in Eureka, CA
• Providers in Eureka, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.