DR. SUSAN MARIE DITTER (NPI# 1710188438) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710188438 |
| Entity Type | Individual |
| Full Name | DR. SUSAN MARIE DITTER |
| Credential | M.D., M.P.H. |
| Practice Address |
2221 Enborg Ln San Jose CA 95128-2608 |
| Practice Telephone | 4088856220 |
| Practice Fax Number | 4088853977 |
| Mailing Telephone | 4088856220 |
| Mailing Fax Number | 4088853977 |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2008-04-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084F0202X |
Psychiatry & Neurology Specialization: Forensic Psychiatry |
0101236675 | VA | Allopathic & Osteopathic Physicians |
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
024803 | GA | Allopathic & Osteopathic Physicians |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
024803 | GA | Allopathic & Osteopathic Physicians |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
0101236675 | VA | Allopathic & Osteopathic Physicians |
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
G87843 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
2221 ENBORG LN |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95128-2608 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164597167 | Shahbaz Amir Khan | Psychiatry & Neurology | 2221 Enborg Ln, San Jose, CA 95128-2608 | 2006-11-22 |
| 1437756913 | Juan Ramon Zago | Licensed Psychiatric Technician | 2221 Enborg Ln, San Jose, CA 95128-2608 | 2020-10-07 |
| 1295385714 | Lawanda Crystal Avila | Counselor | 2221 Enborg Ln, San Jose, CA 95128-2608 | 2019-09-17 |
| 1437616158 | Luis Gilberto Negrete | Rehabilitation Counselor | 2221 Enborg Ln, San Jose, CA 95128-2608 | 2019-02-28 |
| 1649784323 | Jessica Delila Martinez | Community Health Worker | 2221 Enborg Ln, San Jose, CA 95128-2608 | 2017-11-17 |
| 1285055020 | Antonio Tabboga | Counselor | 2221 Enborg Ln, San Jose, CA 95128-2608 | 2013-12-20 |
| 1982045019 | William Ikechukwu Eya | Counselor | 2221 Enborg Ln, San Jose, CA 95128-2608 | 2013-07-17 |
| 1922349356 | Edwin Louie | Pharmacist | 2221 Enborg Ln, San Jose, CA 95128-2608 | 2013-03-11 |
| 1326389701 | Huong Nguyen | Pharmacist | 2221 Enborg Ln, San Jose, CA 95128-2608 | 2013-03-08 |
| 1346581857 | Dennis Michael Dwyer | Pharmacist | 2221 Enborg Ln, San Jose, CA 95128-2608 | 2013-03-07 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982227138 | Ruth Larsen | Social Worker | 850 S. Bascom Avenue, Suite 280, San Jose, CA 95128 | 2020-05-22 |
| 1265067185 | Of Two Minds Psychotherapy | Marriage & Family Therapist | 190 S. Bascom Ave, Ste 130, San Jose, CA 95128 | 2020-03-11 |
| 1982244166 | Cindy Pantoja Escobar | Behavior Technician | 100 O'connor Drive, Suites 21, San Jose, CA 95128 | 2020-01-15 |
| 1104460591 | Katherine Alexandra Misogas | Pharmacist | 777 Turner Dr # 330, San Jose, CA 95128 | 2019-10-29 |
| 1942842216 | Jodie Pierce | Marriage & Family Therapist | 871 Enborg Lane, San Jose, CA 95128 | 2019-10-08 |
| 1003466434 | Dong Mi Cha | Pharmacist | 777 Turner Dr Ste 330, San Jose, CA 95128 | 2019-09-17 |
| 1114571759 | Sleep Well Acupuncture, Inc | Acupuncturist | 1361 S Winchester Blvd Suite 206, San Jose, CA 95128 | 2019-08-01 |
| 1083277677 | Wellocity, Inc | Health Educator | 334 Santana Row, 318, San Jose, CA 95128 | 2019-04-18 |
| 1518428812 | Alexander Diaz | Radiology | 75 South Bascom Ave, San Jose, CA 95128 | 2019-03-28 |
| 1720542103 | Nanci R Price Inc | Chiropractor | 100 O'connor Dr., Ste 27, San Jose, CA 95128 | 2019-01-30 |
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| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295343366 | Bluesky Telepsych, Inc. | Psychiatry & Neurology | 177 Park Ave, San Jose, CA 95113-2259 | 2020-07-15 |
| 1255954145 | Strive Psychiatric Services Inc. | Psychiatry & Neurology | 2570 N 1st St Fl 2, San Jose, CA 95131-1035 | 2020-05-26 |
| 1891293007 | Norman Reynolds | Psychiatry & Neurology | 1730 Hamilton Ave, San Jose, CA 95125-5424 | 2018-01-23 |
| 1861900367 | Golden Gate Psychiatry Associates | Psychiatry & Neurology | 2570 N 1st St Ste 216, San Jose, CA 95131-1035 | 2018-01-18 |
| 1114314846 | Jennifer Atienza Duyanen | Psychiatry & Neurology | 2150 N 1st St Ste 650, San Jose, CA 95131-2031 | 2015-04-21 |
| 1245596329 | Honor Hsin | Psychiatry & Neurology | 5755 Cottle Rd Bldg 24, San Jose, CA 95123-3640 | 2012-04-03 |
| 1124397708 | Beeta Verma | Psychiatry & Neurology | 6120 Hellyer Ave, San Jose, CA 95138-1065 | 2011-12-28 |
| 1093006983 | Yang Xu | Psychiatry & Neurology | 1530 The Alameda, Suite 315, San Jose, CA 95126-2303 | 2011-04-26 |
| 1326277567 | Samer Salmo | Psychiatry & Neurology | 1530 The Alameda Ste 315, San Jose, CA 95126-2303 | 2009-07-09 |
| 1881821791 | Suzanna Lynn Freerksen | Psychiatry & Neurology | 913 Willow St Ste 103, San Jose, CA 95125-2380 | 2009-06-18 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.