Susanna Vakili, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

90193 Issued in CA

Practice address

30290 Rancho Viejo Rd Ste 105
San Juan Capistrano, CA 92675-1575

Phone

(949) 505-3381

NPI assigned

Mar 30, 2016

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 8, 2024 through Jan 8, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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.

• Regents of the University of California Ucsd Head and Neck Surgery

  • Otolaryngology Physician
  • San Diego, CA
  • NPI 1679509962
  NPD (past)

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

{
    "created_epoch": "1459296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460592000000",
    "number": "1457714156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30290 RANCHO VIEJO RD",
            "address_2": "SUITE 105",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926751577",
            "telephone_number": "949-505-3381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30290 RANCHO VIEJO RD STE 105",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926751575",
            "telephone_number": "949-505-3381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAKILI",
        "first_name": "SUSANNA",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-30",
        "last_updated": "2016-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "90193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Ann Tryon, MSW
• Mie Lynn Tsuchimoto, LMFT
• Uformd Corp
• Matthew Urrutia, DPT
• Londres Uso, D.D.S.
• Jesus M Valadez, MD
• Emily Kay Valenzuela, L.AC.
• Emily Van Gilder
• Natalie M. Van Kirk
• Michael E Van Ness, M.D.

• Marriage & Family Therapist in San Juan Capistrano, CA
• Providers in San Juan Capistrano, 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 Apr 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.