Provider Demographics
NPI:1093740466
Name:TOBIN, SUSAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:
Last Name:TOBIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 SALEM ST
Mailing Address - Street 2:SUITE 130
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928-5556
Mailing Address - Country:US
Mailing Address - Phone:530-898-8446
Mailing Address - Fax:530-898-8449
Practice Address - Street 1:630 SALEM ST
Practice Address - Street 2:SUITE 130
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928-5556
Practice Address - Country:US
Practice Address - Phone:530-898-8446
Practice Address - Fax:530-898-8449
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY14006103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PL140060Medicare ID - Type Unspecified