SUSANA JUDITH PRAVER (PAC) – Medical Physician Assistant, NPI 1255434452

SUSANA JUDITH PRAVER (PAC) is a healthcare provider. based in Oakland, California. specializing in Medical Physician Assistant. They hold the professional credentials PAC. They hold a License No. PA10842 (CA). The NPI Number for SUSANA JUDITH PRAVER (PAC) is 1255434452

Main info

Female
46 Years Of Experience
Accepts Medicare Assignment
Name
SUSANA JUDITH PRAVER (PAC)
NPI
1255434452
Phone
(510) 535-4000
Address
1601 FRUITVALE AVE
Enumeration Date
6 September 2006
Last Update Date
6 August 2010

Doctor Profile

Medical School Name
STANFORD UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
9253632000
Graduation Year
1980 (46 years ago)
PAC ID
4981675733
Group Practice PAC ID
1557258282
Professional Enrollment ID
I20040804000962
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for SUSANA JUDITH PRAVER (PAC)

  • 1601, Fruitvale Avenue, Fruitvale, Oakland, Alameda County, California, 94601, United States

    OAKLAND, CA 946012322

    Phone: (510) 535-4000

    Fax: (510) 535-4128

    Type: Mailing

  • 3451, East 12th Street, Fruitvale, Oakland, Alameda County, California, 94601, United States

    OAKLAND, CA 94601

    Phone: (510) 535-3317

    Fax: (510) 535-4248

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 94601)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1557258282View full group profile
NameSpecialtyState
Family PracticeCA
-CA
Nurse PractitionerCA
-CA
Nurse PractitionerCA
O B S T E T R I C S/ G Y N E C O L O G YCA
Family PracticeCA
-CA
O P T O M E T R YCA
Family PracticeCA

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Frequently asked questions

How do I look up SUSANA JUDITH PRAVER (PAC) by NPI?
Use NPI 1255434452 when you need to reference SUSANA JUDITH PRAVER (PAC) in forms, claims, or directories.
Is SUSANA JUDITH PRAVER (PAC)'s NPI currently valid?
The extract we use shows SUSANA JUDITH PRAVER (PAC) as active.
What field does SUSANA JUDITH PRAVER (PAC) work in?
You can think of SUSANA JUDITH PRAVER (PAC) as practicing within Medical Physician Assistant. Clinical services aligned with this taxonomy classification.
What location metadata exists for SUSANA JUDITH PRAVER (PAC)?
The page summarizes Oakland, California for SUSANA JUDITH PRAVER (PAC); expand the address list for detail.
How can I contact SUSANA JUDITH PRAVER (PAC)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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