Provider Demographics
NPI:1477711729
Name:HODDER, SUSAN (MA, MFT)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:
Last Name:HODDER
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3701 SENDA CALMA
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-3066
Mailing Address - Country:US
Mailing Address - Phone:818-631-5455
Mailing Address - Fax:818-222-1301
Practice Address - Street 1:15233 VENTURA BLVD
Practice Address - Street 2:SUITE 1217
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-2201
Practice Address - Country:US
Practice Address - Phone:818-789-6277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT38158101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health