Provider Demographics
NPI:1114044781
Name:REIDER, SUSAN ABRAHAMS (LMFT)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:ABRAHAMS
Last Name:REIDER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:399 LAUREL ST
Mailing Address - Street 2:SUITE #10
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-1951
Mailing Address - Country:US
Mailing Address - Phone:415-762-3629
Mailing Address - Fax:
Practice Address - Street 1:399 LAUREL ST
Practice Address - Street 2:SUITE #10
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-1951
Practice Address - Country:US
Practice Address - Phone:415-762-3629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 37430106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist