Provider Demographics
NPI:1720219710
Name:THOMASON, SUSAN (MFT)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:
Last Name:THOMASON
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 W MISSION ST
Mailing Address - Street 2:#4
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-0402
Mailing Address - Country:US
Mailing Address - Phone:805-682-9313
Mailing Address - Fax:
Practice Address - Street 1:26 W MISSION ST
Practice Address - Street 2:#4
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-0402
Practice Address - Country:US
Practice Address - Phone:805-682-9313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-07
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT36076106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist