Active NPI
Susan Patricia Kaneshiro, PSY.D
- Clinical Psychologist
- Yorba Linda, CA
National Provider Identifier
1225269889
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY 22537
- Practice address
- 17451 Bastanchury Rd
Suite 204, Office 21
Yorba Linda, CA 92886-1857 - Phone
- (714) 404-7398
- Fax
- (888) 958-5485
- NPI assigned
- Jul 30, 2009
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY 22537 | CA | Primary |
Addresses
Primary practice location
17451 Bastanchury Rd
Suite 204, Office 21
Yorba Linda, CA 92886-1857
Mailing address
17451 Bastanchury Rd
Suite 204, Office 21
Yorba Linda, CA 92886-1857
Phone (714) 404-7398
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 |
|---|---|---|---|
| PSY 22537 | CA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oc Counseling and Psychological Services, P.C. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Yorba Linda, CA
- NPI 1528405099
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248912000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445212800000",
"number": "1225269889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17451 BASTANCHURY RD",
"address_2": "SUITE 204, OFFICE 21",
"city": "YORBA LINDA",
"state": "CA",
"postal_code": "928861857",
"telephone_number": "714-404-7398",
"fax_number": "888-958-5485"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17451 BASTANCHURY RD",
"address_2": "SUITE 204, OFFICE 21",
"city": "YORBA LINDA",
"state": "CA",
"postal_code": "928861857",
"telephone_number": "714-404-7398",
"fax_number": "888-958-5485"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KANESHIRO",
"first_name": "SUSAN",
"middle_name": "PATRICIA",
"name_prefix": "Dr.",
"credential": "PSY.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-07-30",
"last_updated": "2015-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY 22537",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yorba Linda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.