Susan Nylen, NFP

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

Practice address

1140 Norman Dr
Suite 101
Manteca, CA 95336-5900

Phone

(209) 825-7748

NPI assigned

Oct 5, 2005

Last updated

Feb 21, 2008By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Craig Bobson North Street Family Practice

  • Adult Medicine Physician
  • Manteca, CA
  • NPI 1821286089
  NPD (past)

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203552000000",
    "number": "1205823077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 NORMAN DR",
            "address_2": "SUITE 101",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953365900",
            "telephone_number": "209-825-7748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 NORMAN DR",
            "address_2": "SUITE 101",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953365900",
            "telephone_number": "209-825-7748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYLEN",
        "first_name": "SUSAN",
        "credential": "NFP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-05",
        "last_updated": "2008-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauri Northcutt
• Vinisha Noti
• Carmen Catherine Nunes, M.F.T
• Chloe Nunez
• Marlene Nuno
• Kevin Robert O'Connor, M.F.T.
• Kevin S. O'Dell, MD
• Maryanne Elizabeth O'Halloran, MS, RN, CNS
• Bolaji Obasuyi
• Brijinder S. Oberai, MD

• Addiction Medicine (Family Medicine) Physician in Manteca, CA
• Providers in Manteca, CA by specialty
• Addiction Medicine (Family Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2008; 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.