Provider Demographics
NPI:1124456876
Name:MORGENSTERN, SUZANNA (PHD)
Entity type:Individual
Prefix:DR
First Name:SUZANNA
Middle Name:
Last Name:MORGENSTERN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 DEODARA ST
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95688-2529
Mailing Address - Country:US
Mailing Address - Phone:918-237-2724
Mailing Address - Fax:
Practice Address - Street 1:805 N LINCOLN ST STE B
Practice Address - Street 2:
Practice Address - City:DIXON
Practice Address - State:CA
Practice Address - Zip Code:95620-2172
Practice Address - Country:US
Practice Address - Phone:707-514-6783
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-16
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 9345103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical