Provider Demographics
NPI:1386839686
Name:GRAF-COTE, SUSAN REEDER (MFT)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:REEDER
Last Name:GRAF-COTE
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MS
Other - First Name:SUSAN
Other - Middle Name:REEDER
Other - Last Name:GRAF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFT
Mailing Address - Street 1:3694 OLD COBBLE RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-4048
Mailing Address - Country:US
Mailing Address - Phone:858-414-0411
Mailing Address - Fax:
Practice Address - Street 1:591 CAMINO DE LA REINA
Practice Address - Street 2:SUITE 918
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3102
Practice Address - Country:US
Practice Address - Phone:858-414-0411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-10
Last Update Date:2016-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 36680106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMFC 36680OtherBBS