Individual provider Active NPI

Susan Guerrero, PSY.D.

  • Clinical Psychologist
  • Santa Rosa, CA
National Provider Identifier
1134460587
Registry record updated Feb 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY25585 Issued in CA
Practice address
144 Stony Point Rd
Santa Rosa, CA 95401-4122
Phone
(707) 521-4550
NPI assigned
Mar 11, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY25585 CA Primary

Addresses

Primary practice location

144 Stony Point Rd
Santa Rosa, CA 95401-4122

Mailing address

PO Box 212
Berkeley, CA 94701-0212
Phone (415) 640-1417

Other practice location 1

1735 Mission St
San Francisco, CA 94103-2417
Phone (415) 554-1450 ext. 206

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
I20150121001463 CA Practitioner - Clinical Psychologist 2365766409 Reassigns benefits to 3 organizations
Practice locations: Santa Rosa, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Psych Strategies Inc a Psychological CorpGroup PAC ID 0446144497, 23 clinicians
Sonoma County Indian Health Project IncGroup PAC ID 2961491238, 31 clinicians

Practice addresses (Care Compare)

1144 Sonoma Ave
Suite 104
Santa Rosa, CA 95405-4812
Phone (510) 406-8198

1160 N Dutton Ave
Suite 230
Santa Rosa, CA 95401-4658
Phone (707) 303-3201

144 Stony Point Rd
Santa Rosa, CA 95401-4122
Phone (707) 521-4545

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY25585CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Axis Community Health Inc Current Accepting new patients
Axis Community Health Inc CurrentSince Aug 17, 2015 Accepting new patients
Axis Community Health Inc CurrentSince Aug 17, 2015 Accepting new patients
Psych Strategies Inc a Psychological Corp CurrentSince Oct 14, 2024 Accepting new patients
Sonoma County Indian Health Project, Inc CurrentSince Mar 26, 2024 Accepting new patients
Sonoma County Indian Health Project, Inc Past Accepting new patients
Sonoma County Indian Health Project, Inc Past Accepting new patients

Locations

4361 Railroad Ave
Pleasanton, CA 94566
Phone (925) 201-6005

1160 N Dutton Ave
Ste 230
Santa Rosa, CA 95401
Phone (707) 303-3201

144 Stony Point Rd
Santa Rosa, CA 95401
Phone (707) 521-4500

Organizations & group practices 7

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": "1362960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1134460587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 212",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947010212",
            "telephone_number": "415-640-1417",
            "fax_number": "415-558-4235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 STONY POINT RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014122",
            "telephone_number": "707-521-4550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1735 Mission St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941032417",
            "country_code": "US",
            "telephone_number": "415-554-1450 x206",
            "fax_number": "415-558-4235",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUERRERO",
        "first_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-11",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY25585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.