Provider Demographics
NPI:1164638664
Name:RHODES, SUSAN KAY (PSYD, HSPP)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:KAY
Last Name:RHODES
Suffix:
Gender:F
Credentials:PSYD, HSPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2710 FLOWER FIELDS WAY
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92010-8332
Mailing Address - Country:US
Mailing Address - Phone:510-914-7317
Mailing Address - Fax:510-792-0802
Practice Address - Street 1:2710 FLOWER FIELDS WAY
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92010-8332
Practice Address - Country:US
Practice Address - Phone:510-914-7317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY-31640103TC0700X, 103TH0100X, 103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service