Provider Demographics
NPI:1053482786
Name:TUTTLE, SUSAN (PHD, MFT)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:
Last Name:TUTTLE
Suffix:
Gender:F
Credentials:PHD, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2345 ERRINGER RD
Mailing Address - Street 2:SUITE 209
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-2235
Mailing Address - Country:US
Mailing Address - Phone:805-584-1732
Mailing Address - Fax:805-584-8368
Practice Address - Street 1:2345 ERRINGER RD
Practice Address - Street 2:SUITE 209
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-2235
Practice Address - Country:US
Practice Address - Phone:805-584-1732
Practice Address - Fax:805-584-8368
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT17144101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health