La Tisha Lynn San Pedro-lintag, LMFT 133780 is a medicare enrolled "Marriage & Family Therapist" provider in Pollock Pines, California. Her current practice location is
3431 Sly Park Rd, Pollock Pines, California. You can reach out to her office (for appointments etc.) via phone at
(209) 975-7919.
La Tisha Lynn San Pedro-lintag 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 1487149407.
Healthcare Provider's Profile
Full Name | La Tisha Lynn San Pedro-lintag |
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Gender | Female |
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Speciality | Marriage & Family Therapist |
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Location | 3431 Sly Park Rd, Pollock Pines, California |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1487149407
- Provider Enumeration Date: 06/22/2018
- Last Update Date: 07/22/2022
Medicare PECOS Information:
- PECOS PAC ID: 4789022302
- Enrollment ID: I20240402002299
Medical Identifiers
Medical identifiers for La Tisha Lynn San Pedro-lintag such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1487149407 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
106H00000X | Marriage & Family Therapist | (* (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. La Tisha Lynn San Pedro-lintag allows following entities to bill medicare on her behalf.
Entity Name | Grow Healthcare Group Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1154994846 PECOS PAC ID: 1850774746 Enrollment ID: O20220809004080 |
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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. La Tisha Lynn San Pedro-lintag 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 |
La Tisha Lynn San Pedro-lintag, LMFT 133780 Po Box 445, Pollock Pines, CA 95726-0445 Ph: (916) 583-4426 | La Tisha Lynn San Pedro-lintag, LMFT 133780 3431 Sly Park Rd, Pollock Pines, CA 95726-9520 Ph: (209) 975-7919 |
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