Active NPI
Susan L Kole, PHD
- Clinical Psychologist
- Redwood City, CA
National Provider Identifier
1093866915
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY18369
- Practice address
- 300 Bradford St
Redwood City, CA 94063-1530 - Phone
- (650) 363-7830
- NPI assigned
- Jan 16, 2007
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY18369 | CA | Primary |
Addresses
Primary practice location
300 Bradford St
Redwood City, CA 94063-1530
Mailing address
PO Box 36088
San Jose, CA 95158-6088
Phone (408) 267-4781
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY18369 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202688000000",
"number": "1093866915",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 36088",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951586088",
"telephone_number": "408-267-4781"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 BRADFORD ST",
"city": "REDWOOD CITY",
"state": "CA",
"postal_code": "940631530",
"telephone_number": "650-363-7830"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOLE",
"first_name": "SUSAN",
"middle_name": "L",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-16",
"last_updated": "2008-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY18369",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redwood City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.