Susana So Ching Chan, RN

Primary specialty

Gerontology Registered NurseTaxonomy code 163WG0600X

License

462255 Issued in CA

Practice address

7200 Bancroft Ave
Oakland, CA 94605-2403

Phone

(510) 828-4308

NPI assigned

Jan 17, 2022

Last updated

Jan 17, 2022By 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 2

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1642377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642377600000",
    "number": "1396496808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33762 RYE TER",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945551471",
            "telephone_number": "510-828-4308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7200 BANCROFT AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946052403",
            "telephone_number": "510-828-4308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "SUSANA",
        "middle_name": "SO CHING",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-17",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "CA",
            "license": "462255",
            "primary": false
        },
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "CA",
            "license": "462255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA BOARD OF REGISTERED NURSING",
            "identifier": "462255",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Susana.Chan2@acgov.org",
            "affiliation": "N",
            "endpointDescription": "employment location",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7200 Bancroft Ave",
            "city": "Oakland",
            "state": "CA",
            "country_code": "US",
            "postal_code": "946052403",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Susana.Chan2@acgov.org",
            "affiliation": "N",
            "endpointDescription": "Alameda County Public Health Department",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "33762 Rye Ter",
            "city": "Fremont",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945551471",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shing Nam Chan, MD
• Stephanie Chan, MD
• Stephany Chan
• Stephen Shih-Hsiung Chan, MD
• Sue Shu-Kwan Chan, M.D.
• Tiffany Chan, F.N.P.-C
• Tony Chan
• Tony Chan, MD
• Vanessa S Chan, M.D.
• Victor K Chan

• Gerontology Registered Nurse in Oakland, CA
• Providers in Oakland, CA by specialty
• Gerontology Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2022; 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.