Provider Demographics
NPI:1306390612
Name:DRESE, SUSAN MARIE (LMFT)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:MARIE
Last Name:DRESE
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 1:2258 SANTA CLARA AVENUE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-4407
Mailing Address - Country:US
Mailing Address - Phone:510-273-9353
Mailing Address - Fax:
Practice Address - Street 1:2258 SANTA CLARA AVENUE
Practice Address - Street 2:SUITE 5
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-4407
Practice Address - Country:US
Practice Address - Phone:510-273-9353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-04
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist