Provider Demographics
NPI:1912860438
Name:BARNDOLLAR, SUSAN (RN)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:BARNDOLLAR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 NORMAL ST RM 2121
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-2653
Mailing Address - Country:US
Mailing Address - Phone:619-725-5501
Mailing Address - Fax:619-725-8073
Practice Address - Street 1:4100 NORMAL ST RM 2121
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2653
Practice Address - Country:US
Practice Address - Phone:619-725-5501
Practice Address - Fax:619-725-8073
Is Sole Proprietor?:No
Enumeration Date:2025-12-03
Last Update Date:2025-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA429237163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool