Michael Barraza, is a medicare enrolled "Psychologist - Clinical" provider in Lakewood, California. His current practice location is
4060 Watson Plaza Dr, Lakewood, California. You can reach out to his office (for appointments etc.) via phone at
(562) 420-6325.
Michael Barraza is licensed to practice in California (license number PSY 23994) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1174641302.
Healthcare Provider's Profile
Full Name | Michael Barraza |
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Gender | Male |
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Speciality | Psychologist - Clinical |
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Location | 4060 Watson Plaza Dr, Lakewood, 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: 1174641302
- Provider Enumeration Date: 03/26/2007
- Last Update Date: 06/13/2012
Medicare PECOS Information:
- PECOS PAC ID: 1153779368
- Enrollment ID: I20231129001240
Medical Identifiers
Medical identifiers for Michael Barraza such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1174641302 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
103TC0700X | Psychologist - Clinical | PSY 23994 (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. Michael Barraza allows following entities to bill medicare on his behalf.
Entity Name | Permanente Medical Group Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710 |
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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. Michael Barraza 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 |
Michael Barraza, 4060 Watson Plaza Dr, Lakewood, CA 90712-4033 Ph: (562) 420-6325 | Michael Barraza, 4060 Watson Plaza Dr, Lakewood, CA 90712-4033 Ph: (562) 420-6325 |
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