Susan Elizabeth Stephens Dierauf, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

G 080393 Issued in CA

Practice address

901 Nevin Ave
Kaiser Richmond Campus
Richmond, CA 94801

Phone

(510) 307-1500

NPI assigned

Aug 30, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Susan Elizabeth Stephens Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235520000000",
    "number": "1205945151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 892",
            "city": "ROSS",
            "state": "CA",
            "postal_code": "949570892",
            "telephone_number": "415-459-3094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 NEVIN AVE",
            "address_2": "KAISER RICHMOND CAMPUS",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "94801",
            "telephone_number": "510-307-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS DIERAUF",
        "first_name": "SUSAN",
        "middle_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2009-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD 21292",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G 080393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "STEPHENS",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• James Starr
• Svetlana Startseva
• Cory Stebbins
• Julie L Steiner, MD
• Jon Eric Stenson, PHD
• Stewart Dialysis LLC
• Alexander Han Stickler, MFTI
• Lareese Beatrice Stitts
• Myles Stranzl
• Molly E. Stullman, PH.D.

• Pediatrics Physician in Richmond, CA
• Providers in Richmond, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2009; 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.