Susan Evich Cozolino, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY17635 Issued in CA

Practice address

3075 Wilshire Blvd
8TH Floor
Los Angeles, CA 90010-1205

Phone

(213) 639-4708

NPI assigned

Oct 5, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Susan Ann Evich Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700972551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11503",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902957503",
            "telephone_number": "213-639-4708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3075 WILSHIRE BLVD",
            "address_2": "8TH FLOOR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900101205",
            "telephone_number": "213-639-4708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COZOLINO",
        "first_name": "SUSAN",
        "middle_name": "EVICH",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY17635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "EVICH",
            "middle_name": "ANN",
            "prefix": "DR.",
            "credential": "PSY.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• James Chris Coyle, MA-CCC, SLP
• Amanda Laura Coyne
• Martin Joel Coyne, M.D.
• Mary Elizabeth Coyner, PHARMD
• Heather Cozen, M.S.
• CP Professional Education and Counseling Services, Inc.
• Cpi Health, Inc.
• CPLM Pathology Outreach Services
• CPSN, Inc
• CR Dygert & Co (W M Solutions)

• Clinical Psychologist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinical Psychologist in California

• 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.

Verify at the official NPI Registry.