Individual provider Active NPI

Susan Davin, N.P.

  • Psychiatric/Mental Health Nurse Practitioner
  • Fresno, CA
National Provider Identifier
1871598623
Registry record updated Aug 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
NPF# 14989 Issued in CA
Practice address
1322 E Shaw Ave Ste 410
Fresno, CA 93710-7904
Phone
(559) 266-1316
Fax
(559) 226-1315
NPI assigned
Jun 17, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NPF# 14989 CA Primary

Addresses

Primary practice location

1322 E Shaw Ave Ste 410
Fresno, CA 93710-7904

Mailing address

1322 E Shaw Ave Ste 410
Fresno, CA 93710-7904
Phone (559) 226-1316

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080417000696 CA Practitioner - Nurse Practitioner 2769560614 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
House Psychiatric Clinic IncGroup PAC ID 4587742432, 14 clinicians

Practice addresses (Care Compare)

1322 E Shaw Ave
Suite 410
Fresno, CA 93710-7904
Phone (559) 226-1316

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NPF# 14989CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
House Psychiatric Clinic, Inc. CurrentSince Jan 19, 2010 Accepting new patients

Locations

1322 E Shaw Ave
Ste 410
Fresno, CA 93710
Phone (559) 226-1316

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186531200000",
    "number": "1871598623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1322 E SHAW AVE STE 410",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937107904",
            "telephone_number": "559-226-1316",
            "fax_number": "559-226-1315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1322 E SHAW AVE STE 410",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937107904",
            "telephone_number": "559-266-1316",
            "fax_number": "559-226-1315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIN",
        "first_name": "SUSAN",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-17",
        "last_updated": "2007-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "NPF# 14989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.