| Doctor Name: | SUSAN JANE SHEEDY |
| NPI Number: | 1316240971 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 383824 |
| Business Practice Address: | 113 S Vine St Suite A Fallbrook, CA - 920282925 |
| Business Phone Number: | 7607232313 |
| Business Fax Number: | 7607230333 |
| Mailing Address: | 79440 Corporate Center Dr, Suite 101 LA QUINTA |
| State: | CA |
| Postal Code: | 922537241 |
| Phone Number: | 7607774067 |
| Fax Number: | 7607774096 |
| NPI Enumeration Date: | 12/20/2010 |
| NPI Last Update Date: | 04/07/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LW0102X |
| License Number: | 383824 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Women's Health |
| Taxonomy Definition: | |