Suzan Janette Etheridge, AMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

125842 Issued in CA

Practice address

3540 Howard Way Ste 150
Costa Mesa, CA 92626-1496

Phone

(714) 638-8343

NPI assigned

Feb 17, 2021

Sex

Female

Sole proprietor

No

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1613520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632096000000",
    "number": "1518550979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3540 HOWARD WAY STE 150",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926261496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3540 HOWARD WAY STE 150",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926261496",
            "telephone_number": "714-638-8343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETHERIDGE",
        "first_name": "SUZAN",
        "middle_name": "JANETTE",
        "credential": "AMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-17",
        "last_updated": "2021-09-20",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "125842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melisa Estrada
• Sara Estrada, LMFT
• Karen Estrella
• Raymond Estrella
• Etc Consultants Inc (Lorphen Medical)
• Ethos Medical Supply, Inc.
• Randiann Ethridge, M.S.
• Kirsten Serena Gonzales Eustace, MS ATC
• Evagelos Coskinas MD a Medical Corporation
• Eval-Docs

• Marriage & Family Therapist in Costa Mesa, CA
• Providers in Costa Mesa, 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 Sep 20, 2021; 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.