Suzanne Moselle Allen, PH.D.
Individual provider Active NPI Clinical Psychologist · Lafayette, CA
NPI 1174744239 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1174744239
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PSY7430 (CA)
- Practice address
- 3249 Mt. Diablo Blvd.
Suite 210
Lafayette, CA 94549 - Phone
- (925) 930-9350
- Fax
- (925) 284-8019
- NPI assigned
- May 2, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
- Opted out of Medicare
- Yes, effective Oct 1, 2017 through Oct 1, 2027
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY7430 | CA | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY7430 | CA | Yes |
Addresses
Primary practice location
3249 Mt. Diablo Blvd.
Suite 210
Lafayette, CA 94549
Mailing address
3249 Mt. Diablo Blvd.
Suite 210
Lafayette, CA 94549
Phone (925) 930-9350
Other providers in Lafayette, CA
- Christina Alba
- Alisha Julia Albertson
- Robin Alexander
- Jane Jolindon Alfonso
- Alixandra Fenton
- Alliance Medical Corporation
- Deanna Alzagha
- Roxanna Ambriz
- Clare Ames-Klein
- Anahat Kaur Sandhu, MD, Inc
All providers in Lafayette, CA · Clinical Psychologist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.