Provider Demographics
NPI:1316982721
Name:NARCISO, EMILY SUZANNE (RD, PA-C)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:SUZANNE
Last Name:NARCISO
Suffix:
Gender:F
Credentials:RD, PA-C
Other - Prefix:MRS
Other - First Name:EMILY
Other - Middle Name:SUZANNE
Other - Last Name:ENTZI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RD, PA-C
Mailing Address - Street 1:300 PASTEUR DR
Mailing Address - Street 2:
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305-2200
Mailing Address - Country:US
Mailing Address - Phone:650-723-4000
Mailing Address - Fax:
Practice Address - Street 1:300 PASTEUR DR
Practice Address - Street 2:
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-2200
Practice Address - Country:US
Practice Address - Phone:650-723-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC05304363AM0700X
NC0010-02325363A00000X
CA54607363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCPENDINGMedicare PIN
MD422201Y9QMedicare UPIN