Priscilla Ann Surdam, MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

39339 Issued in CA

Practice address

200 Channing Ave
Palo Alto, CA 94301-2720

Phone

(650) 688-3076

NPI assigned

Sep 24, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jewish Family and Children'S Services

  • Community/Behavioral Health Agency
  • Palo Alto, CA
  • NPI 1831252337
  NPD (past)
• Jewish Family and Childrens Services

  • Mental Health Counselor
  • San Rafael, CA
  • NPI 1780791020
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023118643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CHANNING AVE",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943012720",
            "telephone_number": "650-688-3076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CHANNING AVE",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943012720",
            "telephone_number": "650-688-3076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURDAM",
        "first_name": "PRISCILLA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "39339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Xiaoguang Sun, L.AC
• Ying Sun
• Sameer Sundrani, MD
• Madison Sunnquist, PHD
• Barbara Suplit, NP
• Kezia Ivanka Surjanto, MD
• Colleen Clare Surmay, P.N.P.
• Iwan Sutana, MBA, MSN, AGACNP-BC
• Saumya Sutaria, M.D.
• Julie H Sutcliffe, PSYD

• Marriage & Family Therapist in Palo Alto, CA
• Providers in Palo Alto, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.