Individual provider Active NPI

Susan Carol Terris, LMFT

  • Marriage & Family Therapist
  • Richmond, CA
National Provider Identifier
1699433276
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
34868 Issued in CA
Practice address
6206 Sutter Ave
Richmond, CA 94804-5353
Phone
(510) 989-2404
NPI assigned
Dec 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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 34868 CA Primary

Addresses

Primary practice location

6206 Sutter Ave
Richmond, CA 94804-5353

Mailing address

6206 Sutter Ave
Richmond, CA 94804-5353
Phone (510) 528-0440

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20260417003248 CA Practitioner - Marriage and Family Therapist 9133695067 Practice locations: Richmond, CA

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Richmond, CA 94804
Phone (510) 989-2404

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34868CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1638316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1699433276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6206 SUTTER AVE",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "948045353",
            "telephone_number": "510-528-0440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6206 SUTTER AVE",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "948045353",
            "telephone_number": "510-989-2404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRIS",
        "first_name": "SUSAN",
        "middle_name": "CAROL",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-01",
        "last_updated": "2021-12-01",
        "certification_date": "2020-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "34868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, CA

Sources for this page

Verify at the official NPI Registry.