Provider Demographics
NPI:1003010141
Name:ACHUFF, SUSAN F (MFT)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:F
Last Name:ACHUFF
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 1:820 E GILBERT ST
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92415-0928
Mailing Address - Country:US
Mailing Address - Phone:909-387-7200
Mailing Address - Fax:909-387-7717
Practice Address - Street 1:820 E GILBERT ST
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92415-6720
Practice Address - Country:US
Practice Address - Phone:909-387-7200
Practice Address - Fax:909-387-7717
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT24776106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist