Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | ||
N | 103TB0200X | Cognitive & Behavioral Psychologist | ||
N | 103TC1900X | Counseling Psychologist | ||
N | 103TF0000X | Family Psychologist | ||
N | 103TH0100X | Health Service | ||
N | 103TP0814X | Psychoanalysis | ||
N | 103TP2701X | Group Psychotherapist |
NPI | 1174778807 |
---|---|
Provider Name | Dr. Susan Zakaria Haggag |
First Address | North Tustin, CA 92705-8627 |
Second Address | North Tustin, CA 92705-8627 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2008 |
Last Update Date | 06/01/2014 |