Susanna Farina, PHD
Individual provider Active NPI Clinical Psychologist · Represa, CA
NPI 1013089945 · NPPES record last updated Oct 8, 2018
Key facts
- NPI
- 1013089945
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PSY#23782 (CA)
- Practice address
- 100 Prison Rd
Represa, CA 95671-3010 - Phone
- (916) 985-8610
- NPI assigned
- Nov 15, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY#23782 | CA | MD | Clinical Psychologist |
| 23782 | CA | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Corrections and Rehabilitation-Headquarters | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY#23782 | CA | Yes |
Addresses
Primary practice location
100 Prison Rd
Represa, CA 95671-3010
Mailing address
100 Prison Rd
Represa, CA 95671-3000
Phone (916) 985-8610
Other providers in Represa, CA
- Grace Louise Downing
- John Phillip Dunlap Jr.
- Shannon Taylor Egan-Mooney
- Marsha Evans
- Dennis Rulon Fairbourn
- Anna Fautz
- Bennett Feinberg
- Ruth S Forde
- Alvin Benjamin Ardales Gaerlan
- James Charles Gallwey
All providers in Represa, CA · Clinical Psychologist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 8, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.