Active NPI
Susan Wooton Reyes, LMFT
- Marriage & Family Therapist
- Montrose, CA
National Provider Identifier
1275612715
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- LMFT35586
- Practice address
- 2039 1/2 Montrose Ave
Montrose, CA 91020 - Phone
- (626) 548-8715
- NPI assigned
- Nov 3, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MFT 35586 | CA | |
| Marriage & Family Therapist | 106H00000X | LMFT35586 | CA | Primary |
Addresses
Primary practice location
2039 1/2 Montrose Ave
Montrose, CA 91020
Mailing address
2039 1/2 Montrose Ave
Montrose, CA 91020
Phone (626) 548-8715
Other names 1
- Susan Diane Wooton
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 |
|---|---|---|---|
| MFT 35586 | CA | MD | Mental Health Counselor |
| LMFT35586 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519776000000",
"number": "1275612715",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2039 1/2 MONTROSE AVE",
"city": "MONTROSE",
"state": "CA",
"postal_code": "91020",
"telephone_number": "626-548-8715"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2039 1/2 MONTROSE AVE",
"city": "MONTROSE",
"state": "CA",
"postal_code": "91020",
"telephone_number": "626-548-8715"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYES",
"first_name": "SUSAN",
"middle_name": "WOOTON",
"name_prefix": "Ms.",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-03",
"last_updated": "2018-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "MFT 35586",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "LMFT35586",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SUSAN",
"last_name": "WOOTON",
"middle_name": "DIANE",
"credential": "LMFT",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Montrose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.