Individual provider Active NPI

Diane L Suitos

  • Registered Nurse
  • Sutter Creek, CA
National Provider Identifier
1376945824
Registry record updated Sep 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
404573 Issued in CA
Practice address
10877 Conductor Blvd
Sutter Creek, CA 95685-9687
Phone
(209) 223-6412
NPI assigned
Sep 16, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 404573 CA Primary

Addresses

Primary practice location

10877 Conductor Blvd
Sutter Creek, CA 95685-9687

Mailing address

10877 Conductor Blvd
Sutter Creek, CA 95685-9687
Phone (209) 223-6412

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

LicenseStateTypeSpecialty
404573CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1410825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410825600000",
    "number": "1376945824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10877 CONDUCTOR BLVD",
            "city": "SUTTER CREEK",
            "state": "CA",
            "postal_code": "956859687",
            "telephone_number": "209-223-6412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10877 CONDUCTOR BLVD",
            "city": "SUTTER CREEK",
            "state": "CA",
            "postal_code": "956859687",
            "telephone_number": "209-223-6412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUITOS",
        "first_name": "DIANE",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-16",
        "last_updated": "2014-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "404573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sutter Creek, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.

Verify at the official NPI Registry.