Susan Phillips Gibson, RPH, NUTRITIONIST

Primary specialty

Geriatric PharmacistTaxonomy code 1835G0303X

License

26015162A Issued in IN

Practice address

1004 Windermere Ave
Menlo Park, CA 94025-2314

Phone

(650) 243-7135

NPI assigned

Nov 25, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1732492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1114743010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 WINDERMERE AVE",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940252314",
            "telephone_number": "650-243-7135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 WINDERMERE AVE",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940252314",
            "telephone_number": "650-243-7135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "SUSAN",
        "middle_name": "PHILLIPS",
        "credential": "RPH, NUTRITIONIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-25",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1835G0303X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Geriatric",
            "state": "IN",
            "license": "26015162A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bethany Jean Gemberling, PT, DPT
• Paul S. Gerber, DDS, MS
• Isabela Ghereben
• Ghufran M Syed
• Mara Renee Giattina, MD
• Indira Kaur Gill, D.M.D., M.S.
• Robin Ginsberg, MFT
• Margaret A Givens, LPT
• Stephanie Go, M.D.
• Marina Gocha, DC

• Geriatric Pharmacist in Menlo Park, CA
• Providers in Menlo Park, CA by specialty
• Geriatric Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; 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.