Devonna Jacobs, is a medicare enrolled "Counselor" provider in San Leandro, California. Her current practice location is
3081 Teagarden St, San Leandro, California. You can reach out to her office (for appointments etc.) via phone at
(510) 347-4620.
Devonna Jacobs is licensed to practice in * (Not Available) (license number ) 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 1003246323.
Healthcare Provider's Profile
| Full Name | Devonna Jacobs |
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| Gender | Female |
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| Speciality | Counselor |
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| Location | 3081 Teagarden St, San Leandro, 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: 1003246323
- Provider Enumeration Date: 11/22/2013
- Last Update Date: 09/11/2019
Medicare PECOS Information:
- PECOS PAC ID: 1557715224
- Enrollment ID: I20230928002681
Medical Identifiers
Medical identifiers for Devonna Jacobs such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1003246323 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103T00000X | Psychologist | (* (Not Available)) | Secondary |
| 101Y00000X | Counselor | (* (Not Available)) | 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. Devonna Jacobs allows following entities to bill medicare on her behalf.
| Entity Name | Privia Medical Group Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1013042480
PECOS PAC ID: 4385682061
Enrollment ID: O20140522000040 |
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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. Devonna Jacobs 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 |
|---|
Devonna Jacobs,
3081 Teagarden St,
San Leandro, CA 94577-5720
Ph: (510) 347-4620 | Devonna Jacobs,
3081 Teagarden St,
San Leandro, CA 94577-5720
Ph: (510) 347-4620 |
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