Provider Demographics
NPI:1538235866
Name:ZIEMER, SUSAN RUTH (MFT)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:RUTH
Last Name:ZIEMER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:561 HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93012-5217
Mailing Address - Country:US
Mailing Address - Phone:805-495-7828
Mailing Address - Fax:805-495-7828
Practice Address - Street 1:101 MOODY CT STE 204
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-6068
Practice Address - Country:US
Practice Address - Phone:805-495-7828
Practice Address - Fax:805-495-7828
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC25236106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist