Healthcare Provider Details

I. General information

NPI: 1073478715
Provider Name (Legal Business Name): SUSAN KITTNER TIPTON LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2227 VINA DEL MAR
OXNARD CA
93035-3631
US

IV. Provider business mailing address

2227 VINA DEL MAR
OXNARD CA
93035-3631
US

V. Phone/Fax

Practice location:
  • Phone: 818-606-0130
  • Fax: 818-606-0130
Mailing address:
  • Phone: 818-606-0130
  • Fax: 818-606-0130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLMFT30973
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: