Individual
SUSAN NYLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NFP
Contact information
Practice address
1140 NORMAN DR, SUITE 101, MANTECA, CA 95336-5900
(209) 825-7748
Mailing address
1140 NORMAN DR, SUITE 101, MANTECA, CA 95336-5900
(209) 825-7748
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
—
CA
Other
Enumeration date
10/05/2005
Last updated
02/21/2008
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