Active NPI
Susanna S. Tan, OD
- Optometrist
- Roseville, CA
National Provider Identifier
1548187909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 36343
- Practice address
- 9221 Sierra College Blvd Ste 130
Roseville, CA 95661-5934 - Phone
- (916) 797-6747
- Fax
- (916) 797-6747
- NPI assigned
- Jul 6, 2026
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 36343 | CA | Primary |
Addresses
Primary practice location
9221 Sierra College Blvd Ste 130
Roseville, CA 95661-5934
Mailing address
9221 Sierra College Blvd Ste 130
Roseville, CA 95661-5934
Phone (916) 797-6747
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1783296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787184000000",
"number": "1548187909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9221 SIERRA COLLEGE BLVD STE 130",
"city": "ROSEVILLE",
"state": "CA",
"postal_code": "956615934",
"telephone_number": "916-797-6747",
"fax_number": "916-797-6747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9221 SIERRA COLLEGE BLVD STE 130",
"city": "ROSEVILLE",
"state": "CA",
"postal_code": "956615934",
"telephone_number": "916-797-6747",
"fax_number": "916-797-6747"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAN",
"first_name": "SUSANNA",
"middle_name": "S.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-07-06",
"last_updated": "2026-08-20",
"certification_date": "2026-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "36343",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Roseville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.