Active NPI
Sue Tin
- Psychiatric/Mental Health Nurse Practitioner
- Irvine, CA
National Provider Identifier
1215352091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 22813
- Practice address
- 62 Discovery
Irvine, CA 92618-3142 - Phone
- (949) 551-4272
- Fax
- (949) 551-6406
- NPI assigned
- Mar 3, 2014
- 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 |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 22813 | CA | Primary |
Addresses
Primary practice location
62 Discovery
Irvine, CA 92618-3142
Mailing address
62 Discovery
Irvine, CA 92618-3142
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 |
|---|---|---|---|
| 22813 | CA | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1393804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1393804800000",
"number": "1215352091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "62 DISCOVERY",
"city": "IRVINE",
"state": "CA",
"postal_code": "926183142"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "62 DISCOVERY",
"city": "IRVINE",
"state": "CA",
"postal_code": "926183142",
"telephone_number": "949-551-4272",
"fax_number": "949-551-6406"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIN",
"first_name": "SUE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-03-03",
"last_updated": "2014-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "CA",
"license": "22813",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irvine, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.