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General NPI Number Information
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NPI Number | 1154238830
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Entity Type | Organization
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Legal Business Name | SUSAN UNDERWOOD MARRIAGE AND FAMILY THERAPY CORPORATION
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Dates
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Enumeration Date | 08/26/2026
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Last Update Date | 08/26/2026
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Provider Practice Location Address
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Address Line | 4811 EUREKA AVE STE B4
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City | YORBA LINDA
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State | CA
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Zip | 92886-3368
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Country | US
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Telephone | 714-455-9033
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Fax |
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Provider Business Mailing Address
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Address Line | 4811 EUREKA AVE STE B4
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City | YORBA LINDA
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State | CA
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Zip | 92886-3368
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | MUHAMMAD ALI
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Credential |
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Telephone | 210-503-0525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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