Individual provider Active NPI

Susan Sharma, PSYD

  • Clinical Psychologist
  • Ventura, CA
National Provider Identifier
1457577280
Registry record updated Dec 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 22787 Issued in CA
Practice address
2590 E Main St Ste 201
Ventura, CA 93003-2619
Phone
(805) 628-2546
NPI assigned
Apr 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY 22787 CA Primary

Addresses

Primary practice location

2590 E Main St Ste 201
Ventura, CA 93003-2619

Mailing address

2590 E Main St Ste 201
Ventura, CA 93003-2619
Phone (805) 628-2546

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230518001206 CA Practitioner - Clinical Psychologist 4385009521 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2590 E Main St
Suite 201
Ventura, CA 93003-2619
Phone (805) 628-2546

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY 22787CAMDClinical Psychologist
22787CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Fathom Psychology, PC Clinical CurrentSince Apr 18, 2023 Accepting new patients

Locations

2590 E Main St
#201
Ventura, CA 93003
Phone (805) 628-2546

260 Maple Ct
Ste 223
Ventura, CA 93003
Phone (805) 628-2546

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765238400000",
    "number": "1457577280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2590 E MAIN ST STE 201",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930032619",
            "telephone_number": "805-628-2546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2590 E MAIN ST STE 201",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930032619",
            "telephone_number": "805-628-2546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARMA",
        "first_name": "SUSAN",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2025-12-09",
        "certification_date": "2025-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 22787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.