Active NPI
Susan Utter, LMFT
- Marriage & Family Therapist
- Pismo Beach, CA
National Provider Identifier
1891813150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 50040
- Practice address
- 330 James Way Ste 180
Pismo Beach, CA 93449-2891 - Phone
- (805) 269-1350
- NPI assigned
- Mar 26, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Marriage & Family Therapist | 106H00000X | 50040 | CA | Primary |
Addresses
Primary practice location
330 James Way Ste 180
Pismo Beach, CA 93449-2891
Mailing address
PO Box 5034
San Luis Obispo, CA 93403-5034
Phone (805) 235-1080
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 50040 | Other | CA | BOARD OF BEHAVIORAL SCIENCES |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50040 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1434931200000",
"number": "1891813150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5034",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934035034",
"telephone_number": "805-235-1080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 JAMES WAY STE 180",
"city": "PISMO BEACH",
"state": "CA",
"postal_code": "934492891",
"telephone_number": "805-269-1350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UTTER",
"first_name": "SUSAN",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-26",
"last_updated": "2015-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "50040",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF BEHAVIORAL SCIENCES",
"identifier": "50040",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pismo Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.