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NPI Code Detail

MEDICARE: SUSAN DUFFY MFT

MEDICARE: SUSAN DUFFY MFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist39983CA

General Provider Information

NPI Number : 1760400485
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN DUFFY MFT
Provider Business Mailing Address
First Line : 1000 QUAIL ST STE 175
Second Line :
City : NEWPORT BEACH
State : CA
Zip : 92660-2766
Country : US
Telephone Number : 949-887-9827
Fax Number :
Provider Business Practice Location Address
First Line : 1000 QUAIL ST
Second Line : SUITE 175
City : NEWPORT BEACH
State : CA
Zip : 92660-2731
Country : US
Telephone Number : 949-887-9827
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2006
Last Update Date : 05/22/2025

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Directions to “ SUSAN DUFFY MFT” Practice Location

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