Susan Lynn Dastic, CRNA
Nurse Anesthetist, Certified Registered in Santa Rosa, CA. Individual provider (NPI-1).
NPI number1487700340
StatusActive
Last updated in NPPESDec 30, 2021
Details
- NPI
- 1487700340
- Entity type
- Individual (NPI-1)
- Name
- Susan Lynn Dastic
- Credential
- CRNA
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 25, 2007
- Last updated
- Dec 30, 2021
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | rn3916680 | CA | Yes |
Practice location
401 Bicentennial WaySanta Rosa, CA 95403-2149
Phone 707-571-4000
Mailing address
3507 Hanover PlSanta Rosa, CA 95404-7640
Phone 707-578-8821
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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