Susan Elaine O'Malley

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA12011 Issued in CA

Practice address

2410 Samaritan Dr
Suite 201
San Jose, CA 95124-3909

Phone

(408) 371-9010

Fax

(408) 371-2633

NPI assigned

Apr 26, 2006

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194220800000",
    "number": "1568429447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 SAMARITAN DR",
            "address_2": "SUITE 201",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951243909",
            "telephone_number": "408-371-9010",
            "fax_number": "408-371-2633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 SAMARITAN DR",
            "address_2": "SUITE 201",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951243909",
            "telephone_number": "408-371-9010",
            "fax_number": "408-371-2633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'MALLEY",
        "first_name": "SUSAN",
        "middle_name": "ELAINE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-26",
        "last_updated": "2007-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA12011",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "260226",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "0PA120110",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Linda Ann O'Keeffe, PAC
• Jacqueline Maureen O'Leary, MD
• Jennifer Lynn O'Leary, LCSW/LICSW
• Megan O'Mahony
• Katherine O'Malley
• Deborah O'Meara, R.N.
• Kenyai O'Neal, AMFT
• Amanda O'Neill, BCBA
• Meleina O'Rourke
• Michael S. O'Shea, MS, ATC, CSCS

• Physician Assistant in San Jose, CA
• Providers in San Jose, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2007; 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.