Susan Thompson San Tara, MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

43157 Issued in CA

Practice address

2915 Martin Luther King Jr. Way
Berkeley, CA 94703

Phone

(510) 452-6156

Fax

(510) 548-8998

NPI assigned

Jan 26, 2010

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

Other names 1

• Ms. Susan Thmpson San Roman Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1264464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264464000000",
    "number": "1982935292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2915 MARTIN LUTHER KING JR. WAY",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "94703",
            "telephone_number": "510-452-6156",
            "fax_number": "510-548-8998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2915 MARTIN LUTHER KING JR. WAY",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "94703",
            "telephone_number": "510-452-6156",
            "fax_number": "510-548-8998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAN TARA",
        "first_name": "SUSAN",
        "middle_name": "THOMPSON",
        "name_prefix": "Ms.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-26",
        "last_updated": "2010-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "43157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "SAN ROMAN",
            "middle_name": "THMPSON",
            "prefix": "MS.",
            "credential": "MFT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Marriage & Family Therapist in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.