Rosanna Gustafson, is a medicare enrolled "Social Worker - Clinical" provider in San Bernardino, California. Her current practice location is
900 E Gilbert St Cottage # 4, San Bernardino, California. You can reach out to her office (for appointments etc.) via phone at
(909) 387-7020.
Rosanna Gustafson is licensed to practice in California (license number 82654) 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 1669874202.
Healthcare Provider's Profile
| Full Name | Rosanna Gustafson |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 900 E Gilbert St Cottage # 4, San Bernardino, 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: 1669874202
- Provider Enumeration Date: 09/25/2014
- Last Update Date: 05/11/2018
Medicare PECOS Information:
- PECOS PAC ID: 0547613853
- Enrollment ID: I20240201003693
Medical Identifiers
Medical identifiers for Rosanna Gustafson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1669874202 | NPI | - | NPPES |
| 82654 | Medicaid | CA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | 37127 (California) | Secondary |
| 1041C0700X | Social Worker - Clinical | 82654 (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. Rosanna Gustafson allows following entities to bill medicare on her behalf.
| Entity Name | Tiffani Taft Marriage And Family Therapy Professional Corporation |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1992329528
PECOS PAC ID: 3779909767
Enrollment ID: O20200820003915 |
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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. Rosanna Gustafson 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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Rosanna Gustafson,
26001 Redlands Blvd,
Redlands, CA 92373-7762
Ph: (909) 825-7084 | Rosanna Gustafson,
900 E Gilbert St Cottage # 4,
San Bernardino, CA 92415-0920
Ph: (909) 387-7020 |
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