Individual
SUSAN DUSENBURY SEQUEIRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
2500 MERCED ST, SAN LEANDRO, CA 94577-4201
(510) 454-1000
Mailing address
2500 MERCED ST, SAN LEANDRO, CA 94577-4201
(510) 454-1000
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
3037
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
217218
NURSING LICENSE
CA
Enumeration date
12/04/2006
Last updated
07/09/2015
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