Individual provider Active NPI

Susan Naomi Ogata, PHD

  • Clinical Psychologist
  • Huntington Beach, CA
National Provider Identifier
1821028648
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY11821 Issued in CA
Practice address
16168 Beach Blvd
Suite 241
Huntington Beach, CA 92647-3816
Phone
(714) 742-2408
NPI assigned
Jul 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY11821 CA Primary

Addresses

Primary practice location

16168 Beach Blvd
Suite 241
Huntington Beach, CA 92647-3816

Mailing address

16168 Beach Blvd
Suite 241
Huntington Beach, CA 92647-3816
Phone (714) 742-2408

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
I20050616001187 CA Practitioner - Clinical Psychologist 2163466434 Practice locations: Huntington Beach, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

16152 Beach Blvd
Suite 269
Huntington Beach, CA 92647-3864
Phone (714) 742-2408

16168 Beach Blvd
Suite 241
Huntington Beach, CA 92647-3890

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY11821CAMDClinical Psychologist
11821CAMDAcupuncturist

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821028648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16168 BEACH BLVD",
            "address_2": "SUITE 241",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926473816",
            "telephone_number": "714-742-2408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16168 BEACH BLVD",
            "address_2": "SUITE 241",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926473816",
            "telephone_number": "714-742-2408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGATA",
        "first_name": "SUSAN",
        "middle_name": "NAOMI",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY11821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

Verify at the official NPI Registry.