Active NPI
Susan Elizabeth Hanaburgh, MFT INTERN BBS 58008
- Marriage & Family Therapist
- Newark, CA
National Provider Identifier
1083931836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 58008
- Practice address
- 39899 Balentine Drive #212
Family Service of the Tri-Cities
Newark, CA 94560 - Phone
- (510) 491-5780
- NPI assigned
- May 3, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 58008 | CA | Primary |
Addresses
Primary practice location
39899 Balentine Drive #212
Family Service of the Tri-Cities
Newark, CA 94560
Mailing address
39899 Balentine Drive
Family Service of the Tri-Cities
Newark, CA 94560
Phone (510) 491-5780
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
| License | State | Type | Specialty |
|---|---|---|---|
| 58008 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1272844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1272844800000",
"number": "1083931836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39899 BALENTINE DRIVE",
"address_2": "FAMILY SERVICE OF THE TRI-CITIES",
"city": "NEWARK",
"state": "CA",
"postal_code": "94560",
"telephone_number": "510-491-5780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39899 BALENTINE DRIVE #212",
"address_2": "FAMILY SERVICE OF THE TRI-CITIES",
"city": "NEWARK",
"state": "CA",
"postal_code": "94560",
"telephone_number": "510-491-5780"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANABURGH",
"first_name": "SUSAN",
"middle_name": "ELIZABETH",
"name_prefix": "Ms.",
"credential": "MFT INTERN BBS 58008",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-05-03",
"last_updated": "2010-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "58008",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newark, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.