Susan Marie Overhauser, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

29951 Issued in CA

Practice address

3468 Mt Diablo Blvd Ste B203
Lafayette, CA 94549-7120

Phone

(925) 386-6062

Fax

(510) 222-2090

NPI assigned

Dec 7, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

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

Specialty

Clinical Psychologist

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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 Institute for Psychotherapy

  • Voluntary or Charitable Agency
  • San Rafael, CA
  • NPI 1760403794
  NPD (past)
• Community Institute for Psychotherapy

  • Community/Behavioral Health Agency
  • San Rafael, CA
  • NPI 1780995258
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1449446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549152000000",
    "number": "1326413063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3468 MT DIABLO BLVD STE B203",
            "city": "LAFAYETTE",
            "state": "CA",
            "postal_code": "945497120",
            "telephone_number": "925-386-6062",
            "fax_number": "510-222-2090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3468 MT DIABLO BLVD STE B203",
            "city": "LAFAYETTE",
            "state": "CA",
            "postal_code": "945497120",
            "telephone_number": "925-386-6062",
            "fax_number": "510-222-2090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1330 Lincoln Ave Ste 201",
            "address_2": "Community Institute for Psychotherapy",
            "address_purpose": "LOCATION",
            "city": "San Rafael",
            "state": "CA",
            "postal_code": "949012142",
            "country_code": "US",
            "telephone_number": "415-459-5999",
            "fax_number": "415-459-5602",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5134 La Honda Rd Ste C",
            "address_purpose": "LOCATION",
            "city": "El Sobrante",
            "state": "CA",
            "postal_code": "948033356",
            "country_code": "US",
            "telephone_number": "925-386-6062",
            "fax_number": "510-222-2090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OVERHAUSER",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-07",
        "last_updated": "2019-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "29951",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "29951",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1326413063",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lillian Orson, M.D.
• Caitlyn Hill Ortenberg, PT
• Morenike F Oshi-Ojuri, PSYD
• Seth Robert Osterman, D.D.S., M.S.
• Renee Lynn Outlaw, CMT, LMT,
• Breana Owens
• Elizabeth Owens, PHD
• Lucia Marie Owens, D.C.
• Christopher T Oyoung, RPH
• Linda Pacheco

• Clinical Psychologist in Lafayette, CA
• Providers in Lafayette, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.