Individual provider Active NPI

Susan Haradon, PHD

  • Marriage & Family Therapist
  • La Mesa, CA
National Provider Identifier
1841289246
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
CAMIZ990 Issued in CA
Practice address
4700 Spring St
Ste 306
La Mesa, CA 91941-5263
Phone
(619) 462-1611
Fax
(619) 460-8093
NPI assigned
Oct 18, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X CAPSY6075 CA
Marriage & Family Therapist 106H00000X CAMIZ990 CA Primary

Addresses

Primary practice location

4700 Spring St
Ste 306
La Mesa, CA 91941-5263

Mailing address

4700 Spring St
Ste 306
La Mesa, CA 91941-5263
Phone (619) 462-1611

Other identifiers 1

IdentifierTypeStateIssuer
PL0060750MedicaidCA

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
I20040302000650 CA Practitioner - Clinical Psychologist 0941197289 Practice locations: La Mesa, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4700 Spring St
Suite 306
La Mesa, CA 91942-2294
Phone (619) 462-1611

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CAPSY6075CAMDClinical Psychologist
CAMIZ990CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1841289246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 SPRING ST",
            "address_2": "STE 306",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919415263",
            "telephone_number": "619-462-1611",
            "fax_number": "619-460-8093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 SPRING ST",
            "address_2": "STE 306",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919415263",
            "telephone_number": "619-462-1611",
            "fax_number": "619-460-8093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARADON",
        "first_name": "SUSAN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-18",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "CAPSY6075",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "CAMIZ990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PL0060750",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

Verify at the official NPI Registry.