Rolando E Goubaud-reyna, LCSW is a medicare enrolled "Social Worker - Clinical" provider in San Jose, California. His current practice location is
160 E Virginia St Ste 280, San Jose, California. You can reach out to his office (for appointments etc.) via phone at
(408) 938-2113.
Rolando E Goubaud-reyna is licensed to practice in California (license number LCS 17993) 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 1811194897.
Healthcare Provider's Profile
| Full Name | Rolando E Goubaud-reyna |
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| Gender | Male |
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| Speciality | Social Worker - Clinical |
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| Location | 160 E Virginia St Ste 280, San Jose, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1811194897
- Provider Enumeration Date: 07/02/2007
- Last Update Date: 03/16/2023
Medicare PECOS Information:
- PECOS PAC ID: 4486962404
- Enrollment ID: I20150924001821
Medical Identifiers
Medical identifiers for Rolando E Goubaud-reyna such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1811194897 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | 1041C0700X (California) | Secondary |
| 1041C0700X | Social Worker - Clinical | LCS 17993 (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. Rolando E Goubaud-reyna allows following entities to bill medicare on his behalf.
| Entity Name | Gardner Family Health Network Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1699841528
PECOS PAC ID: 5890859375
Enrollment ID: O20191217001965 |
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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. Rolando E Goubaud-reyna 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 |
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Rolando E Goubaud-reyna, LCSW
160 E Virginia St Ste 280,
San Jose, CA 95112-5817
Ph: () - | Rolando E Goubaud-reyna, LCSW
160 E Virginia St Ste 280,
San Jose, CA 95112-5817
Ph: (408) 938-2113 |
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