Susan Oakson Bystry, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY17015 Issued in CA

Practice address

12966 Euclid St Ste 280
Garden Grove, CA 92840-9202

Phone

(714) 823-4770

NPI assigned

Jul 21, 2006

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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.

• Pathways Community Services LLC

  dba Clarvida

  • Community/Behavioral Health Agency
  • Pico Rivera, CA
  • NPI 1639364862
  NPD (past)

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613433600000",
    "number": "1699796383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12966 EUCLID ST STE 280",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928409202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12966 EUCLID ST STE 280",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928409202",
            "telephone_number": "714-823-4770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYSTRY",
        "first_name": "SUSAN",
        "middle_name": "OAKSON",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY17015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danica M Bustamante
• Marilynda Bustamante
• Alena Buteau
• Steven Buu
• Tung Buu, D.C.
• Ryan Byun
• C3 Patients Association
• Ca Urgent Care
• Frida Caballero
• Elizabeth Cabanas Ramirez

• Clinical Psychologist in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2021; 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.