Active NPI
Susan S Courtney, PHD
- Clinical Psychologist
- Upland, CA
National Provider Identifier
1639152382
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY9243
- Practice address
- 954 W Foothill Blvd
#A
Upland, CA 91786 - Phone
- (909) 946-4222
- Fax
- (909) 946-8243
- NPI assigned
- Nov 28, 2005
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY9243 | CA | Primary |
Addresses
Primary practice location
954 W Foothill Blvd
#A
Upland, CA 91786
Mailing address
13193 Central Avenue
Suite 200
Chino, CA 91710
Phone (909) 902-9111
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY9243 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1639152382",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13193 CENTRAL AVENUE",
"address_2": "SUITE 200",
"city": "CHINO",
"state": "CA",
"postal_code": "91710",
"telephone_number": "909-902-9111",
"fax_number": "909-902-9199"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "954 W FOOTHILL BLVD",
"address_2": "#A",
"city": "UPLAND",
"state": "CA",
"postal_code": "91786",
"telephone_number": "909-946-4222",
"fax_number": "909-946-8243"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COURTNEY",
"first_name": "SUSAN",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY9243",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Upland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.