Autumn Jefferson, in Los Angeles, CA - Medicare Psychologist Provider

Autumn Jefferson, is a medicare enrolled "Psychologist - Clinical" provider in Los Angeles, California. Her current practice location is 4211 Avalon Blvd, Los Angeles, California. You can reach out to her office (for appointments etc.) via phone at (323) 432-5185.

Autumn Jefferson is licensed to practice in California (license number PSY33479) 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 1659409654.

Contact Information

	Autumn Jefferson,
	4211 Avalon Blvd, Los Angeles, CA 90011-5622
	(323) 432-5185
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Autumn Jefferson
Gender	Female
Speciality	Psychologist - Clinical
Location	4211 Avalon Blvd, Los Angeles, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1659409654
Provider Enumeration Date: 03/01/2007
Last Update Date: 10/16/2024

Medicare PECOS Information:

PECOS PAC ID: 3173990728
Enrollment ID: I20221110001727

Medical Identifiers

Medical identifiers for Autumn Jefferson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1659409654	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC0700X	Psychologist - Clinical	PSY33479 (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. Autumn Jefferson allows following entities to bill medicare on her behalf.

Entity Name	Executive Mental Health, Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1275670036 PECOS PAC ID: 0345209102 Enrollment ID: O20160512000302

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. Autumn Jefferson 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
Autumn Jefferson, 5943 Ocean Terrace Dr, Rancho Palos Verdes, CA 90275-5756 Ph: (310) 418-9117	Autumn Jefferson, 4211 Avalon Blvd, Los Angeles, CA 90011-5622 Ph: (323) 432-5185

Reviews and Comments

Psychologist in Los Angeles, CA

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Molly Cevasco, PH.D., BCBA Psychologist Medicare: Medicare Enrolled Practice Location: 4650 W Sunset Blvd, Ms #53, Los Angeles, CA 90027 Phone: 323-361-3849
Dr. Adam Vogel, PSY.D. Psychologist Medicare: Medicare Enrolled Practice Location: 621 S Virgil Ave, #300, Los Angeles, CA 90005 Phone: 213-368-5400

Autumn Jefferson, - Medicare Psychologist in Los Angeles, CA