Individual
DR. SUSAN RAY TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
3350 LA JOLLA VILLAGE DR # 116B, SAN DIEGO, CA 92161-0002
(858) 552-8585
(858) 642-3557
Mailing address
3350 LA JOLLA VILLAGE DR # 116B, SAN DIEGO, CA 92161-0002
(858) 552-8585
(858) 642-3557
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
17625
CA
103TA0400X
Addiction (Substance Use Disorder) Psychologist
17625
CA
103TC0700X
Clinical Psychologist
17625
CA
103TP2701X
Group Psychotherapy Psychologist
Primary
17625
CA
Other
Enumeration date
10/17/2006
Last updated
09/11/2025
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