Provider Demographics
NPI:1699977660
Name:BIANCALANA, SUSAN
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:BIANCALANA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 BAKER ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-4305
Mailing Address - Country:US
Mailing Address - Phone:415-867-8151
Mailing Address - Fax:415-567-1365
Practice Address - Street 1:730 BAKER ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-4305
Practice Address - Country:US
Practice Address - Phone:415-867-8151
Practice Address - Fax:415-567-1365
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2012-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator