Susanne Ross, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

NP10116 Issued in CA

Practice address

1910 California St
Eureka, CA 95501-2870

Phone

(925) 381-8915

NPI assigned

Jun 9, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Susanne Boatman Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677369600000",
    "number": "1952342925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 CALIFORNIA ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955012899",
            "telephone_number": "707-443-9747",
            "fax_number": "707-269-1332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 CALIFORNIA ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955012870",
            "telephone_number": "925-381-8915"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3260 Sacramento St",
            "address_2": "Over 60 Health Center",
            "address_purpose": "LOCATION",
            "city": "Berkeley",
            "state": "CA",
            "postal_code": "947022739",
            "country_code": "US",
            "telephone_number": "510-601-6060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSS",
        "first_name": "SUSANNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2023-02-26",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "10116",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP10116",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "NP10116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSANNE",
            "last_name": "BOATMAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jacob Daniel Rosen, LMFT107103
• Wayne E Roslosnik, R.P.T.
• Benjamin Berkley Ross
• Richard Don Ross
• Steven Mark Ross, RN
• Victoria Nell Rosser
• Steve Roth, PH.D.
• Myrna Rousseau, OTR,L/ CHT
• Wendell Neil Row, DDS
• Thea Jeanne Rowan, ASW

• Gerontology Nurse Practitioner in Eureka, CA
• Providers in Eureka, CA by specialty
• Gerontology Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2023; 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.