Individual provider Active NPI

Susie Ro, LCSW

  • Clinical Social Worker
  • San Diego, CA
National Provider Identifier
1083122972
Registry record updated Jul 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
79974 Issued in CA
Practice address
8765 Aero Dr Ste 228
San Diego, CA 92123-1785
Phone
(619) 776-9408
NPI assigned
Jan 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 79974 CA Primary

Addresses

Primary practice location

8765 Aero Dr Ste 228
San Diego, CA 92123-1785

Mailing address

3355 Par Dr
La Mesa, CA 91941-8031
Phone (808) 260-5705

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190123003909 CA Practitioner - Clinical Social Worker 0042557498 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
79974CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group, Inc CurrentSince Nov 15, 2023 Accepting new patients
Permanente Medical Group Inc CurrentSince Nov 15, 2023 Accepting new patients
Soultenders Psychological Services, Inc. Clinical CurrentSince Jul 2, 2026 Accepting new patients
Susie Ro, Licensed Clinical Social Worker, Path to Healing, Inc, Current Accepting new patients
Permanente Medical Group Inc Current Accepting new patients
Soultenders, Inc. CurrentSince Oct 31, 2025 Accepting new patients

Locations

41 E Foothill Blvd
Ste 102
Arcadia, CA 91006
Phone (626) 701-4249

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

419 W Foothill Blvd
Monrovia, CA 91016
Phone (626) 701-4249

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

151 N Kraemer Blvd
Ste 100
Placentia, CA 92870
Phone (714) 577-2271

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

2401 Merced St
San Leandro, CA 94577
Phone (510) 618-5979

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1515801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753056000000",
    "number": "1083122972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3355 PAR DR",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919418031",
            "telephone_number": "808-260-5705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8765 AERO DR STE 228",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231785",
            "telephone_number": "619-776-9408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RO",
        "first_name": "SUSIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-13",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "79974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.