Individual provider Active NPI

Suellen S Eschenbach, RN, NP

  • Nurse Practitioner
  • Santa Rosa, CA
National Provider Identifier
1255414009
Registry record updated Oct 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11666 Issued in CA
Practice address
751 Lombardi CT
Santa Rosa, CA 95407-6798
Phone
(707) 547-2222
Fax
(707) 547-2229
NPI assigned
Oct 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 255252 CA
Nurse Practitioner 363L00000X 11666 CA Primary

Addresses

Primary practice location

751 Lombardi CT
Santa Rosa, CA 95407-6798

Mailing address

751 Lombardi CT
Santa Rosa, CA 95407-6798
Phone (707) 547-2222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
255252CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Rosa Community Health Centers CurrentSince Oct 10, 2024 Accepting new patients
Santa Rosa Community Health Centers Current Accepting new patients
Santa Rosa Community Health Centers CurrentSince Oct 10, 2024 Accepting new patients
Providence Medical Foundation Past Accepting new patients

Locations

751 Lombardi Ct
Santa Rosa, CA 95407
Phone (707) 547-2222

751 Lombardi Ct
Ste B
Santa Rosa, CA 95407
Phone (707) 547-2220

3569 Round Barn Cir
Santa Rosa, CA 95403

Interoperability endpoints

  • Direct secure messaging: seschenbach627846@direct.ochin.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318464000000",
    "number": "1255414009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 LOMBARDI CT",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954076798",
            "telephone_number": "707-547-2222",
            "fax_number": "707-547-2229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 LOMBARDI CT",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954076798",
            "telephone_number": "707-547-2222",
            "fax_number": "707-547-2229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESCHENBACH",
        "first_name": "SUELLEN",
        "middle_name": "S",
        "credential": "RN, NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2011-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "255252",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "11666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.