Sara Ajifu - Tully, LCSW in Fountain Valley, CA - Medicare Social Worker Provider

Sara Ajifu - Tully, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Fountain Valley, California. Her current practice location is 17100 Euclid St, Fountain Valley, California. You can reach out to her office (for appointments etc.) via phone at (714) 966-8171.

Sara Ajifu - Tully is licensed to practice in California (license number 80892) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1124528104.

Contact Information

	Sara Ajifu - Tully, LCSW
	17100 Euclid St, Fountain Valley, CA 92708-4004
	(714) 966-8171
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Sara Ajifu - Tully
Gender	Female
Speciality	Social Worker - Clinical
Location	17100 Euclid St, Fountain Valley, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1124528104
Provider Enumeration Date: 02/16/2018
Last Update Date: 10/25/2021

Medicare PECOS Information:

PECOS PAC ID: 0244625101
Enrollment ID: I20220311002080

Medical Identifiers

Medical identifiers for Sara Ajifu - Tully such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1124528104	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	80892 (California)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Sara Ajifu - Tully allows following entities to bill medicare on her behalf.

Entity Name	Southern California Permanente Medical Group
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1770515280 PECOS PAC ID: 6002729175 Enrollment ID: O20031110000678

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Sara Ajifu - Tully is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Sara Ajifu - Tully, LCSW 11170 Warner Ave Ste 206, Fountain Valley, CA 92708-4014 Ph: (714) 966-8171	Sara Ajifu - Tully, LCSW 17100 Euclid St, Fountain Valley, CA 92708-4004 Ph: (714) 966-8171

Reviews and Comments

Social Worker in Fountain Valley, CA

Marisa Jill Cherry, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 16027 Brookhurst St # I-2006, Fountain Valley, CA 92708 Phone: 949-436-5023
Miss Valerie Ann Riddle, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 18785 Brookhurst St, Fountain Valley, CA 92708 Phone: 714-975-1719
Jeanette Razo-gonzalez, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 17870 Newhope St Ste 104-327, Fountain Valley, CA 92708 Phone: 626-268-3226
Mina Pham, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 17150 Newhope St Ste 205, Fountain Valley, CA 92708 Phone: 949-431-6374
Guadalupe Liset Gallegos, MSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 18350 Mount Langley St Ste 220, Fountain Valley, CA 92708 Phone: 714-378-2620
Miss Gemma Lara De Blas Williams, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 17350 Mount Herrmann St, Suite A, Fountain Valley, CA 92708 Phone: 714-444-3463 Fax: 714-444-1768
Karla Jeannette Edwards, Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 10101 Slater Ave Ste 241, Fountain Valley, CA 92708 Phone: 714-378-2620 Fax: 714-378-2631

Sara Ajifu - Tully, LCSW - Medicare Clinical Social Worker in Fountain Valley, CA