Provider Demographics
NPI:1366724601
Name:SODERMAN, SUSAN (LMFT)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:
Last Name:SODERMAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:735 STATE ST STE 532
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-5555
Mailing Address - Country:US
Mailing Address - Phone:805-697-4488
Mailing Address - Fax:
Practice Address - Street 1:735 STATE ST STE 532
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-5555
Practice Address - Country:US
Practice Address - Phone:805-697-4488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-13
Last Update Date:2024-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA98962106H00000X, 106H00000X
CA70893101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health