Provider Demographics
NPI:1528250735
Name:ARNDT, SUSAN JEAN (MA)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:JEAN
Last Name:ARNDT
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MRS
Other - First Name:SUSAN
Other - Middle Name:JEAN
Other - Last Name:GERBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:505-A SAN MARIN DRIVE SUITE 150
Mailing Address - Street 2:SAN MARIN PSYCHOTHERAPY
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94945
Mailing Address - Country:US
Mailing Address - Phone:415-755-7818
Mailing Address - Fax:
Practice Address - Street 1:505-A SAN MARIN DRIVE SUITE 150
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94945
Practice Address - Country:US
Practice Address - Phone:415-755-7818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-11
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA53489106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health