Active NPI
Susan Dekom
- Addiction (Substance Use Disorder) Counselor
- San Mateo, CA
National Provider Identifier
1457590770
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- Practice address
- 818 N Delaware St Apt 411
San Mateo, CA 94401-1525 - Phone
- (650) 921-2512
- Fax
- (650) 348-8824
- NPI assigned
- Feb 10, 2009
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Primary |
Addresses
Primary practice location
818 N Delaware St Apt 411
San Mateo, CA 94401-1525
Mailing address
818 N Delaware St Apt 411
San Mateo, CA 94401-1525
Phone (650) 921-2512
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1234224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1234224000000",
"number": "1457590770",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "818 N DELAWARE ST APT 411",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944011525",
"telephone_number": "650-921-2512",
"fax_number": "650-348-8824"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "818 N DELAWARE ST APT 411",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944011525",
"telephone_number": "650-921-2512",
"fax_number": "650-348-8824"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEKOM",
"first_name": "SUSAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-02-10",
"last_updated": "2009-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Mateo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.