Individual
SUSANA SO CHING CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
7200 BANCROFT AVE, OAKLAND, CA 94605-2403
(510) 828-4308
Mailing address
33762 RYE TER, FREMONT, CA 94555-1471
(510) 828-4308
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
462255
CA
163WG0600X
Gerontology Registered Nurse
Primary
462255
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
462255
CALIFORNIA BOARD OF REGISTERED NURSING
CA
Enumeration date
01/17/2022
Last updated
01/17/2022
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