Susanne Michelle Reynolds, ICADCII

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

2931 Prospect Ave
Concord, CA 94518-1025

Phone

(925) 676-4840

Fax

(925) 676-4840

NPI assigned

Jun 6, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Bi-Bett

  • Substance Abuse Rehabilitation Facility
  • Concord, CA
  • NPI 1154526333
  NPD (past)

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

{
    "created_epoch": "1496707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1417486283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2931 PROSPECT AVE",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945181025",
            "telephone_number": "925-676-4840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2931 PROSPECT AVE",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945181025",
            "telephone_number": "925-676-4840",
            "fax_number": "925-676-4840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "SUSANNE",
        "middle_name": "MICHELLE",
        "credential": "ICADCII",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-06",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUBSTANCE ABUSE DISORDER REHABILITATION FACILITY",
            "identifier": "324500000X",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria Fernanda Reyna Iberico
• Araceli Reyna Rodriguez
• Mary C Reyna, PSYD
• Asa Tayvon Reynolds Sr.
• Sara Alice Reynolds
• Azareli Reynoso
• Maryssa Reynoso
• Reza Khazaie,DDS,Inc
• Yasamin Rezaei Tehrani
• Majid Rezaei

• Addiction (Substance Use Disorder) Counselor in Concord, CA
• Providers in Concord, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.