Susan K Badrtalei, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY20484 Issued in CA

Practice address

12373 Lewis St
Garden Grove, CA 92840-4676

Phone

(949) 533-4049

Fax

(714) 867-6033

NPI assigned

Sep 25, 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

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

Specialty

Clinical Psychologist

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Psychfitness, Apmc

  • Psychiatry Physician
  • Garden Grove, CA
  • NPI 1235504564
  NPD (past)

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377216000000",
    "number": "1871693085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22581 PUNTAL LANA",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926921337",
            "telephone_number": "949-533-4049",
            "fax_number": "949-380-1471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12373 LEWIS ST",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928404676",
            "telephone_number": "949-533-4049",
            "fax_number": "714-867-6033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADRTALEI",
        "first_name": "SUSAN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2013-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY20484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George Albert Baca
• Yvonne Vu Bach, M.D.
• Alyssa Bacon-Liu
• Joey Ann Mae Badar, MSN, APRN, FNP-BC
• Badii Lee Dental Corporation, Inc.
• Baek Chiropractic-Acupuncture, Inc
• Jehyun Baek, ACUPUNCTURIST
• Sharon Sunghee Baek, D.C., L.AC
• Briana Baesa
• Melody Jean Bailey, COTA

• 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 Aug 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.