Active NPI
Susan Gruss Odekerken, M.F.T.
- Marriage & Family Therapist
- Newhall, CA
National Provider Identifier
1154600559
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFC18498
- Practice address
- 21137 Placerita Canyon Rd
Newhall, CA 91321-1922 - Phone
- (661) 857-0953
- NPI assigned
- Aug 16, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 | MFC18498 | CA | Primary |
Addresses
Primary practice location
21137 Placerita Canyon Rd
Newhall, CA 91321-1922
Mailing address
21137 Placerita Canyon Rd
Newhall, CA 91321-1922
Phone (661) 857-0953
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 |
|---|---|---|---|
| MFC18498 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1313452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1313452800000",
"number": "1154600559",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21137 PLACERITA CANYON RD",
"city": "NEWHALL",
"state": "CA",
"postal_code": "913211922",
"telephone_number": "661-857-0953"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21137 PLACERITA CANYON RD",
"city": "NEWHALL",
"state": "CA",
"postal_code": "913211922",
"telephone_number": "661-857-0953"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ODEKERKEN",
"first_name": "SUSAN",
"middle_name": "GRUSS",
"name_prefix": "Mrs.",
"credential": "M.F.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-08-16",
"last_updated": "2011-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFC18498",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newhall, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.