Tiffany Diane Blanton, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Gardena, California. Her current practice location is
108 W Victoria St, Gardena, California. You can reach out to her office (for appointments etc.) via phone at
(310) 715-2020.
Tiffany Diane Blanton is licensed to practice in California (license number 88912) 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 1639450711.
Healthcare Provider's Profile
| Full Name | Tiffany Diane Blanton |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 108 W Victoria St, Gardena, 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: 1639450711
- Provider Enumeration Date: 09/02/2011
- Last Update Date: 12/03/2021
Medicare PECOS Information:
- PECOS PAC ID: 5890190920
- Enrollment ID: I20210826003161
Medical Identifiers
Medical identifiers for Tiffany Diane Blanton such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1639450711 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | 88912 (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. Tiffany Diane Blanton allows following entities to bill medicare on her behalf.
| Entity Name | Southern California Permanente Medical Group |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1316979834
PECOS PAC ID: 6002729175
Enrollment ID: O20040126000823 |
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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. Tiffany Diane Blanton 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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Tiffany Diane Blanton, LCSW
108 W Victoria St,
Gardena, CA 90248-3523
Ph: (310) 715-2020 | Tiffany Diane Blanton, LCSW
108 W Victoria St,
Gardena, CA 90248-3523
Ph: (310) 715-2020 |
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