Active NPI
Susan Jane Riesel, WHPAC
- Physician Assistant
- Arcata, CA
National Provider Identifier
1174619787
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA50880
- Practice address
- 770 10TH Street
Arcata, CA 95521 - Phone
- (707) 826-8610
- Fax
- (707) 826-8623
- NPI assigned
- Oct 4, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA50880 | CA | Primary |
Addresses
Primary practice location
770 10TH Street
Arcata, CA 95521
Mailing address
670 Ninth Street
Suite 203
Arcata, CA 95521
Phone (707) 826-8633
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA50880 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174619787",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "670 NINTH STREET",
"address_2": "SUITE 203",
"city": "ARCATA",
"state": "CA",
"postal_code": "95521",
"telephone_number": "707-826-8633",
"fax_number": "707-826-8638"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "770 10TH STREET",
"city": "ARCATA",
"state": "CA",
"postal_code": "95521",
"telephone_number": "707-826-8610",
"fax_number": "707-826-8623"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIESEL",
"first_name": "SUSAN",
"middle_name": "JANE",
"credential": "WHPAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA50880",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Arcata, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.