Sushma Rani Patla, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LMFT111093 Issued in CA

Practice address

800 Scenic Drive
Modesto, CA 95350

Phone

(209) 525-7339

Fax

(209) 558-4321

NPI assigned

Jan 30, 2007

Reactivated

Jun 3, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Sushma Rani Madahar Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559520000000",
    "number": "1437296597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3636 GAMBLE OAK LANE",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "95205",
            "telephone_number": "510-921-4059",
            "fax_number": "209-451-1048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 SCENIC DRIVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "95350",
            "telephone_number": "209-525-7339",
            "fax_number": "209-558-4321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATLA",
        "first_name": "SUSHMA",
        "middle_name": "RANI",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2019-06-03",
        "deactivation_date": "2019-04-21",
        "reactivation_date": "2019-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT111093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MENTAL HEALTH",
            "identifier": "101YM0800X",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSHMA",
            "last_name": "MADAHAR",
            "middle_name": "RANI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Pathways to Mending Feelings Psychotherapy Training Program Inc
• Pratibha Patil, MD
• Elizabeth Patino Loarca, LVN
• Nathaniel Patino
• Perla B Patino
• Victoria Patrick
• Irene Patry
• Alexandra Patterson, LVN
• Jade Patterson
• Raysha Jeanette Patterson, NP

• Marriage & Family Therapist in Modesto, CA
• Providers in Modesto, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2019; 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.