Dr Doribeth Tardillo, PSYD is a medicare enrolled "Psychologist" provider in San Jose, California. Her current practice location is
2400 Moorpark Ave Ste 300, San Jose, California. You can reach out to her office (for appointments etc.) via phone at
(323) 494-3762.
Dr Doribeth Tardillo is licensed to practice in California (license number PSY33087) 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 1720330681.
Healthcare Provider's Profile
| Full Name | Dr Doribeth Tardillo |
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| Gender | Female |
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| Speciality | Psychologist |
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| Location | 2400 Moorpark Ave Ste 300, 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: 1720330681
- Provider Enumeration Date: 10/02/2012
- Last Update Date: 06/14/2023
Medicare PECOS Information:
- PECOS PAC ID: 6406242536
- Enrollment ID: I20220329002917
Medical Identifiers
Medical identifiers for Dr Doribeth Tardillo such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1720330681 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 106H00000X | Marriage & Family Therapist | LMFT95947 (California) | Secondary |
| 103T00000X | Psychologist | PSY33087 (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. Dr Doribeth Tardillo allows following entities to bill medicare on her behalf.
| Entity Name | Asian Americans For Community Involvement Of Santa Clara County |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1750490363
PECOS PAC ID: 7719880533
Enrollment ID: O20040129000646 |
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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. Dr Doribeth Tardillo 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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Dr Doribeth Tardillo, PSYD
2400 Moorpark Ave, Ste 300,
San Jose, CA 95128-2680
Ph: (408) 975-2730 | Dr Doribeth Tardillo, PSYD
2400 Moorpark Ave Ste 300,
San Jose, CA 95128-2680
Ph: (323) 494-3762 |
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