Individual provider Active NPI

Susan Lea Luallen, MFT

  • Marriage & Family Therapist
  • Chico, CA
National Provider Identifier
1023184579
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
42259 Issued in CA
Practice address
564 Rio Lindo Avenue
Suite 204
Chico, CA 95926
Phone
(530) 879-3950
Fax
(530) 879-3949
NPI assigned
Nov 27, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 42259 CA Primary

Addresses

Primary practice location

564 Rio Lindo Avenue
Suite 204
Chico, CA 95926

Mailing address

2602 Chico River Road
Chico, CA 95928
Phone (530) 343-8886

Other identifiers 1

IdentifierTypeStateIssuer
42259OtherCABOARD OF BEHAVIORAL SCIEN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
42259CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023184579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2602 CHICO RIVER ROAD",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "95928",
            "telephone_number": "530-343-8886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "564 RIO LINDO AVENUE",
            "address_2": "SUITE 204",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "95926",
            "telephone_number": "530-879-3950",
            "fax_number": "530-879-3949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUALLEN",
        "first_name": "SUSAN",
        "middle_name": "LEA",
        "name_prefix": "Mrs.",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "42259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF BEHAVIORAL SCIEN",
            "identifier": "42259",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chico, CA

Sources for this page

  • 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.