Healthcare Provider Details

I. General information

NPI: 1174777908
Provider Name (Legal Business Name): SUSAN BREDHOFF MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2008
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5210 CARPINTERIA AVE # 104
CARPINTERIA CA
93013-2428
US

IV. Provider business mailing address

349 ASH AVE SPC 46
CARPINTERIA CA
93013-2233
US

V. Phone/Fax

Practice location:
  • Phone: 906-684-0263
  • Fax:
Mailing address:
  • Phone: 310-994-9029
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number014502
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: