DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

SUSAN J NISSIM

Active Sole Proprietor

Gerontology Occupational Therapist · SAN RAFAEL, CA

Registration Details

NPI Number
1073337200
Provider Type
Individual
Gender
Female
NPI Issued
Nov 13, 2024 (1.4369938044284 yrs)
Last Updated
Nov 13, 2024
License
6516 (CA)
Sole Proprietor
Yes

Practice Information

Address
35 SANTIAGO WAY
SAN RAFAEL, CA, 949031790
Browse CA providers · Browse ZIP 94903
Phone
4153028643
Primary Specialty
Gerontology Occupational Therapist
225XG0600X

Other Gerontology Occupational Therapist Providers in SAN RAFAEL, CA

Name Credential NPI
CASSANDRA WHITTINGTON 1295089837
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.