Active NPI
Susan Tancredi, ANP-BC
- Occupational Health Nurse Practitioner
- San Diego, CA
National Provider Identifier
1558484972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Health Nurse Practitioner
- License
- 440373
- Practice address
- 10777 Science Center Dr
Ohw, CB1/1167
San Diego, CA 92121-1111 - Phone
- (858) 622-8860
- NPI assigned
- Apr 9, 2007
- 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 |
|---|---|---|---|---|
| Occupational Health Nurse Practitioner | 363LX0106X | 440373 | CA | Primary |
Addresses
Primary practice location
10777 Science Center Dr
Ohw, CB1/1167
San Diego, CA 92121-1111
Mailing address
PO Box 400111
San Diego, CA 92140-0111
Phone (619) 298-4488
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 |
|---|---|---|---|
| 440373 | CA | MD | Occupational Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1265932800000",
"number": "1558484972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 400111",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921400111",
"telephone_number": "619-298-4488"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10777 SCIENCE CENTER DR",
"address_2": "OHW, CB1/1167",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921211111",
"telephone_number": "858-622-8860"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TANCREDI",
"first_name": "SUSAN",
"credential": "ANP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-09",
"last_updated": "2010-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "363LX0106X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Occupational Health",
"state": "CA",
"license": "440373",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.