Provider Demographics
NPI:1174086300
Name:FRYER, SUHMER N (NEMT , EDUCATOR)
Entity type:Individual
Prefix:MISS
First Name:SUHMER
Middle Name:N
Last Name:FRYER
Suffix:
Gender:F
Credentials:NEMT , EDUCATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 294
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95617-0294
Mailing Address - Country:US
Mailing Address - Phone:530-551-2182
Mailing Address - Fax:
Practice Address - Street 1:4110 BEECHCRAFT WAY
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834-4000
Practice Address - Country:US
Practice Address - Phone:530-219-3070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-14
Last Update Date:2019-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA172V00000X, 174H00000X
172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver
No172V00000XOther Service ProvidersCommunity Health Worker
No174H00000XOther Service ProvidersHealth Educator