Suzanne Kathryn Tavano, RN, PH.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY9950 Issued in CA

Practice address

20 N San Pedro Rd
San Rafael, CA 94903-4188

Phone

(925) 286-5056

NPI assigned

Jul 16, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy, Registered Nurse

State licenses

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

{
    "created_epoch": "1437004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437696000000",
    "number": "1992189351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 N SAN PEDRO RD",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949034188",
            "telephone_number": "925-286-5056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 N SAN PEDRO RD",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949034188",
            "telephone_number": "925-286-5056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVANO",
        "first_name": "SUZANNE",
        "middle_name": "KATHRYN",
        "name_prefix": "Dr.",
        "credential": "RN, PH.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-16",
        "last_updated": "2015-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY9950",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "W213270",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Johnston DDS Inc
• Frank Peter Tarantino, PHARM.D.
• Christine Tarradelles, L.AC
• Paul Taruskin
• Joseph Tato
• Al Charleston Taylor
• Christine Taylor, COTA/L
• Gabrielle Marie Taylor, M.D.
• Harold Lee Taylor Jr.
• Hutton Hinsdale Taylor, MFT

• Clinical Psychologist in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.

Verify at the official NPI Registry.