Susanna Russell, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

23511 Issued in CA

Practice address

312 W J St
Los Banos, CA 93635-4073

Phone

(209) 827-6178

Fax

(209) 827-6179

NPI assigned

Nov 12, 2010

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

Other names 1

• Susanna Louie Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Central Valley Cardiovascular Medical Group, Inc

  • Medical Specialty Clinic/Center
  • Turlock, CA
  • NPI 1962750224
  NPD (past)

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

{
    "created_epoch": "1289520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289520000000",
    "number": "1093016610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 W J ST",
            "city": "LOS BANOS",
            "state": "CA",
            "postal_code": "936354073",
            "telephone_number": "209-827-6178",
            "fax_number": "209-827-6179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 W J ST",
            "city": "LOS BANOS",
            "state": "CA",
            "postal_code": "936354073",
            "telephone_number": "209-827-6178",
            "fax_number": "209-827-6179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "SUSANNA",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-12",
        "last_updated": "2010-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "23511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSANNA",
            "last_name": "LOUIE",
            "credential": "MPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lorena Rubio Trejo
• Rosamaria Elvara Rucobo
• Maria Jose Ruiz Ruiz Villa
• Stephanie Ruiz
• Scott Kevin Russell, M.P.T.
• Patricia Ruvalcaba - Gomez
• Lennen Ruvalcaba-Jimenez
• Doha Saeb
• Ghassan Saeb, M.D.
• Rhionna Nikol Saenz

• Physical Therapist in Los Banos, CA
• Providers in Los Banos, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2010; 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.