Active NPI
Susan Stivers
- Professional Counselor
- Rancho Santa Margarita, CA
National Provider Identifier
1336468370
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- PSY D16953
- Practice address
- 22431 Antonio Parkway
Suite B160-694
Rancho Santa Margarita, CA 92688 - Phone
- (949) 742-1476
- NPI assigned
- May 28, 2010
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | PSY D16953 | CA | Primary |
Addresses
Primary practice location
22431 Antonio Parkway
Suite B160-694
Rancho Santa Margarita, CA 92688
Mailing address
22431 Antonio Parkway
Suite B160-694
Rancho Santa Margarita, CA 92688
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 D16953 | CA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1275004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1275004800000",
"number": "1336468370",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22431 ANTONIO PARKWAY",
"address_2": "SUITE B160-694",
"city": "RANCHO SANTA MARGARITA",
"state": "CA",
"postal_code": "92688"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22431 ANTONIO PARKWAY",
"address_2": "SUITE B160-694",
"city": "RANCHO SANTA MARGARITA",
"state": "CA",
"postal_code": "92688",
"telephone_number": "949-742-1476"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STIVERS",
"first_name": "SUSAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-05-28",
"last_updated": "2010-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CA",
"license": "PSY D16953",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rancho Santa Margarita, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.