Suzanne Jessup

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

1682 Novato Blvd
Novato, CA 94947-7000

Phone

(415) 473-2721

NPI assigned

Sep 19, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• County of Marin

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Novato, CA
  • NPI 1679081335
  NPD (past)

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

{
    "created_epoch": "1537315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1649754318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 NORTHGATE DR",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949033680",
            "telephone_number": "415-526-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1682 NOVATO BLVD",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949477000",
            "telephone_number": "415-473-2721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESSUP",
        "first_name": "SUZANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-19",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "CA",
            "license": "MPSS-FWQXYL",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer I. Dole DDS Inc (Healthy Smiles of Marin)
• Deonna Donnyell Jennings
• Leann Kay Jensen, P.T.
• Rebecca Nicoll Jensen, OTR CHT
• Deborah Ann Jernberg
• Deidre Jimenez
• Michele Jodoin, PA
• Joel S. Erickson, M.D., Inc. (Laser Light Treatment Center)
• John Elloway MD a Professional Corp (n/a)
• Jashaun Johnson

• Counselor in Novato, CA
• Providers in Novato, CA by specialty
• Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2023; 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.