Individual provider Active NPI

Susan E. Figueroa, PHN, MSN,PSY.D.

  • Registered Nurse
  • Fairfield, CA
National Provider Identifier
1730385022
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
558165 Issued in CA
Practice address
4113 Fall Creek CT
Fairfield, CA 94534-6637
Phone
(707) 563-0157
NPI assigned
Jun 22, 2007
Last updated
Jul 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Registered Nurse 163W00000X 558165 CA Primary

Addresses

Primary practice location

4113 Fall Creek CT
Fairfield, CA 94534-6637

Mailing address

444 Georgia St
Vallejo, CA 94590-6005
Phone (707) 563-0157

Other practice location 1

1116 Legend Cir
Vallejo, CA 94591-8679
Phone (707) 563-0157

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
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
558165CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
MSK Solutions CurrentSince Jul 28, 2024 Accepting new patients
Ann Martin Center Past Accepting new patients

Locations

444 Georgia St
Vallejo, CA 94590
Phone (707) 563-0157

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1182470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1730385022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 GEORGIA ST",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945906005",
            "telephone_number": "707-563-0157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4113 FALL CREEK CT",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945346637",
            "telephone_number": "707-563-0157"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1116 Legend Cir",
            "address_purpose": "LOCATION",
            "city": "Vallejo",
            "state": "CA",
            "postal_code": "945918679",
            "country_code": "US",
            "telephone_number": "707-563-0157",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FIGUEROA",
        "first_name": "SUSAN",
        "middle_name": "E.",
        "credential": "PHN, MSN,PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-22",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "558165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; 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.