Provider Demographics
NPI:1942517156
Name:SCHMIDT, SUSAN V (LMFT)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:V
Last Name:SCHMIDT
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 1:6520 LONETREE BLVD
Mailing Address - Street 2:#130
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95765-5874
Mailing Address - Country:US
Mailing Address - Phone:916-765-9046
Mailing Address - Fax:916-771-0220
Practice Address - Street 1:6520 LONETREE BLVD
Practice Address - Street 2:#130
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95765-5874
Practice Address - Country:US
Practice Address - Phone:916-765-9046
Practice Address - Fax:916-771-0220
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-09
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34311106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist