Individual provider Active NPI

Susan Irish-Zelener, MFT

  • Marriage & Family Therapist
  • Redlands, CA
National Provider Identifier
1952690737
Registry record updated Apr 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
33862 Issued in CA
Practice address
255 Terracina Blvd
204
Redlands, CA 92373-4870
Phone
(909) 798-1763
Fax
(909) 307-6405
NPI assigned
Apr 1, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 33862 CA Primary

Addresses

Primary practice location

255 Terracina Blvd
204
Redlands, CA 92373-4870

Mailing address

255 Terracina Blvd
204
Redlands, CA 92373-4870
Phone (909) 798-1763

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
I20180314001655 CA Practitioner - Clinical Psychologist 9739441544 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2000
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Inlandpsych Redlands IncGroup PAC ID 0749337467, 9 clinicians

Practice addresses (Care Compare)

255 Terracina Blvd
Suite 204
Redlands, CA 92373-4870
Phone (909) 798-1763

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
29288CAMDSports Physician Chiropractor
33862CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Inlandpsych Redlands Inc CurrentSince Feb 1, 2018 Accepting new patients
Inlandpsych Redlands Inc Current Accepting new patients

Locations

701 Highland Springs Ave
Ste 7
Beaumont, CA 92223
Phone (951) 849-7455

255 Terracina Blvd
Ste 204
Redlands, CA 92373
Phone (909) 496-1266

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1301616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301616000000",
    "number": "1952690737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 TERRACINA BLVD",
            "address_2": "204",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923734870",
            "telephone_number": "909-798-1763",
            "fax_number": "909-307-6405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 TERRACINA BLVD",
            "address_2": "204",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923734870",
            "telephone_number": "909-798-1763",
            "fax_number": "909-307-6405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRISH-ZELENER",
        "first_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-01",
        "last_updated": "2011-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "33862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

Verify at the official NPI Registry.