Susan Vanmouwerik, PH.D.

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

PSY11890 Issued in CA

Practice address

402 W Ojai Ave
Suite 203
Ojai, CA 93023-2406

Phone

(805) 646-7900

NPI assigned

May 21, 2007

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 names 1

• Mrs. Susan V.M. Jackson Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185148800000",
    "number": "1467660332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 W OJAI AVE",
            "address_2": "SUITE 203",
            "city": "OJAI",
            "state": "CA",
            "postal_code": "930232406",
            "telephone_number": "805-646-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 W OJAI AVE",
            "address_2": "SUITE 203",
            "city": "OJAI",
            "state": "CA",
            "postal_code": "930232406",
            "telephone_number": "805-646-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANMOUWERIK",
        "first_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2007-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "CA",
            "license": "PSY11890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "JACKSON",
            "middle_name": "V.M.",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• All providers in Ojai, CA
• Counseling Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2007; 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.