Healthcare Provider Details

I. General information

NPI: 1821389560
Provider Name (Legal Business Name): SUSAN LYNN MAXFIELD MS, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2011
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1727 MALVASIA AVE
TULARE CA
93274-7843
US

IV. Provider business mailing address

1727 MALVASIA AVE
TULARE CA
93274-7843
US

V. Phone/Fax

Practice location:
  • Phone: 559-750-7518
  • Fax:
Mailing address:
  • Phone: 559-750-7518
  • Fax: 559-686-7920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number48920
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: