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DR. SUSAN RAY TATE PH.D. NPI 1184705261


NPI Information

NPI: 1184705261
Provider Name: DR. SUSAN RAY TATE, PH.D.
Classification: Psychologist - 103TA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
3350 LA JOLLA VILLAGE DR # 116B
SAN DIEGO, CA
ZIP 92161
Phone: (858) 552-8585
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DR. Susan Ray Tate, PH.D. is an addiction (substance use disorder) psychologist in San Diego, CA. The provider is a psychologist with a proficiency that involves the application of psychological treatment of addiction stemming from the use of alcohol and other psychoactive substances (e.g., nicotine, marijuana, cocaine, heroin) or behavioral addictions (e.g., gambling) with the aim of cessation or reduction of use and/or the amelioration of emotional, behavioral, interpersonal and other problems arising from the addictive behavior. DR. Susan Ray Tate, PH.D. NPI is 1184705261. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3350 LA JOLLA VILLAGE DR # 116B
SAN DIEGO, CA
ZIP 92161-002
Phone: (858) 552-8585
Fax: (858) 642-3557

The enumeration date for this NPI number is 10/17/2006 and was last updated on 7/8/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TA0400XPsychologistAddiction (Substance Use Disorder)17625CALIFORNIAYes
2103TC0700XPsychologistClinical17625CALIFORNIAX
3103T00000XPsychologist17625CALIFORNIAX
4103TP2701XPsychologistGroup Psychotherapy17625CALIFORNIAX

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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