Provider Demographics
NPI:1043607757
Name:JAMES, SUSAN (PHD, LMFT)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:JAMES
Suffix:
Gender:F
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2490 HOSPITAL DR STE 205
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-4124
Mailing Address - Country:US
Mailing Address - Phone:650-962-4500
Mailing Address - Fax:650-962-4504
Practice Address - Street 1:2490 HOSPITAL DR STE 205
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-4124
Practice Address - Country:US
Practice Address - Phone:650-962-4500
Practice Address - Fax:650-962-4504
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-20
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC30257106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist