Maria Elisabeth Sulistio, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY18394 Issued in CA

Practice address

5200 Warner Ave
Suite 208
Huntington Beach, CA 92649-4057

Phone

(714) 293-2375

NPI assigned

Jun 30, 2006

Last updated

Aug 6, 2012By the provider in NPPES

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

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

Specialty

Clinical Psychologist

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344211200000",
    "number": "1538198031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 WARNER AVE STE 208",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926494033",
            "telephone_number": "714-293-2375",
            "fax_number": "714-369-8157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 WARNER AVE",
            "address_2": "SUITE 208",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926494057",
            "telephone_number": "714-293-2375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULISTIO",
        "first_name": "MARIA",
        "middle_name": "ELISABETH",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2012-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY18394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sublime Health Solutions LLC
• James Suchy, MD
• Allyson Suda
• Suelene Y. Chen, D.D.S. Inc.
• Aya Sugimoto
• Graciela Kuata Sullivan, DDS., MS
• Lacey Sullivan, BCBA
• Leah Barbara Sullivan, FNP-C
• Pamela C Sullivan, MD
• Melanie Summerhayes, PSY.D

• Clinical Psychologist in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.