Candice Diane Peterson, in Vallejo, CA - Medicare Counselor Provider

Candice Diane Peterson, is a medicare enrolled "Counselor - Mental Health" provider in Vallejo, California. Her current practice location is 902 Tuolumne St, Vallejo, California. You can reach out to her office (for appointments etc.) via phone at (707) 648-8121.

Candice Diane Peterson is licensed to practice in * (Not Available) (license number ) 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 1992956379.

Contact Information

	Candice Diane Peterson,
	902 Tuolumne St, Vallejo, CA 94590-4641
	(707) 648-8121
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Candice Diane Peterson
Gender	Female
Speciality	Counselor - Mental Health
Location	902 Tuolumne St, Vallejo, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1992956379
Provider Enumeration Date: 10/03/2008
Last Update Date: 10/09/2008

Medicare PECOS Information:

PECOS PAC ID: 0345605176
Enrollment ID: I20230501002772

Medical Identifiers

Medical identifiers for Candice Diane Peterson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1992956379	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	(* (Not Available))	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. Candice Diane Peterson allows following entities to bill medicare on her behalf.

Entity Name	Mood Clinical, P. C.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1922675644 PECOS PAC ID: 4981080769 Enrollment ID: O20220930002640

Entity Name	My Concierge Psychotherapy Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1740978394 PECOS PAC ID: 6103271044 Enrollment ID: O20231012000332

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. Candice Diane Peterson 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
Candice Diane Peterson, 1972 Maybelle Dr, Pleasant Hill, CA 94523-2708 Ph: (925) 798-7191	Candice Diane Peterson, 902 Tuolumne St, Vallejo, CA 94590-4641 Ph: (707) 648-8121

Reviews and Comments

Counselor in Vallejo, CA

Leata Jeames, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2201 Tuolumne St, Vallejo, CA 94589 Phone: 707-558-1777 Fax: 707-558-1770
Ned L Jacobs, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1017 Tennessee St, Vallejo, CA 94590 Phone: 707-647-1520
Tiffany Marie Tyler, Counselor Medicare: Not Enrolled in Medicare Practice Location: 908 Tuolumne St, Vallejo, CA 94590 Phone: 707-648-8121 Fax: 707-648-8129
Michelle Reneta Ortiz, Counselor Medicare: Not Enrolled in Medicare Practice Location: 126 Ohio St, Vallejo, CA 94590 Phone: 415-707-2577 Fax: 707-644-5501
Mr. Bjay Jones, Counselor Medicare: Not Enrolled in Medicare Practice Location: 236 Georgia Street, Vallejo, CA 94590 Phone: 510-229-2786
Mrs. Tracy Jean Royer, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1017 Tennessee St, Vallejo, CA 94590 Phone: 707-647-1520
Annette Thomas Bowman, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1131 Cunningham St, Vallejo, CA 94590 Phone: 415-492-0818 Fax: 415-492-0834

Candice Diane Peterson, - Medicare Counselor in Vallejo, CA