Individual provider Active NPI

Susan K Watkins, AMFT

  • Marriage & Family Therapist
  • Burbank, CA
National Provider Identifier
1669038998
Registry record updated May 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
111530 Issued in CA
Practice address
2211 W Magnolia Blvd Ste 145
Burbank, CA 91506-1753
Phone
(310) 853-3638
NPI assigned
May 13, 2019
Last updated
May 13, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 111530 CA Primary

Addresses

Primary practice location

2211 W Magnolia Blvd Ste 145
Burbank, CA 91506-1753

Mailing address

28081 Liana LN
Valencia, CA 91354-1483
Phone (661) 713-2525

Other practice location 1

25000 Avenue Stanford
Valencia, CA 91355-4553
Phone (310) 853-3638

Other identifiers 1

IdentifierTypeStateIssuer
111530OtherCACALIFORNIA DEPARTMENT OF CONSUMER AFFAIRS BOARD OF BEHAVIORAL SCIENCES

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
111530CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Hope Therapy Center Marriage & Family Therapist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1557705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557705600000",
    "number": "1669038998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28081 LIANA LN",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913541483",
            "telephone_number": "661-713-2525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 W MAGNOLIA BLVD STE 145",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915061753",
            "telephone_number": "310-853-3638"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25000 Avenue Stanford",
            "address_purpose": "LOCATION",
            "city": "Valencia",
            "state": "CA",
            "postal_code": "913554553",
            "country_code": "US",
            "telephone_number": "310-853-3638",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "SUSAN",
        "middle_name": "K",
        "credential": "AMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-13",
        "last_updated": "2019-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "111530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA DEPARTMENT OF CONSUMER AFFAIRS BOARD OF BEHAVIORAL SCIENCES",
            "identifier": "111530",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2019; 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.