| Doctor Name: | DR. SUSAN MARINEL GREENE |
| NPI Number: | 1346334711 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | PSY6684 |
| Business Practice Address: | 11100 San Pablo Ave Suite 216 El Cerrito, CA - 945302194 |
| Business Phone Number: | 5102338402 |
| Business Fax Number: | 5102338402 |
| Mailing Address: | 11100 San Pablo Ave, Suite 216 EL CERRITO |
| State: | CA |
| Postal Code: | 945302194 |
| Phone Number: | 5102338402 |
| Fax Number: | 5102338402 |
| NPI Enumeration Date: | 10/03/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PSY6684 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |