SUSANA JUDITH PRAVER PAC
NPI 1255434452
Physician Assistant - Medical in Oakland, CA

Q: What is Susana Praver's NPI number?

The NPI number for Susana Praver is 1255434452. It was assigned to this individual provider in the NPPES registry on September 6, 2006. The provider is also known as Shoshana Judith Praver.

Q: What is Susana Praver's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Susana Praver was last updated on August 6, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 06, 2006PECOS Enrolled

3451 E 12TH ST, OAKLAND, CA 94601(510) 535-3317(510) 535-4248 Get Directions Write a Review

NPPES record last updated: August 6, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Susana Judith Praver Pac NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUSANA JUDITH PRAVER PAC (NPI 1255434452) is an individual medical provider in Oakland, California, licensed in California (PA10842) and active in the NPI registry since September 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1255434452

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameSUSANA JUDITH PRAVERCredential: PAC

Location Address3451 E 12TH STOakland, CA 94601

Mailing Address1601 Fruitvale AveOakland, CA 94601-2322 · (510) 535-4000 · Fax (510) 535-4128

Phone(510) 535-3317

Fax(510) 535-4248

Sole ProprietorNo

Enumeration DateSeptember 6, 2006

Last NPPES UpdateAugust 6, 2010

✔ NPI 1255434452 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in CA · PA10842

3451 E 12TH ST, Oakland, CA 94601

Open in Google Maps ↗

Other Names 1

Other Name (5)Shoshana Judith Praver

Other Identifiers 4

OtherZZZ29799ZCA · Fqhc Medicare Part B

OtherHAP72021FCA · Fpact

Other55-1975CA · Fqhc Medicare Part A

MedicaidFHC71021FCA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Susana Judith Praver Pac is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Leave this field empty

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. KEN MAKIO MARRINER M.D.

Family Medicine