Dr Dudleasa Stacie Harris-thomas, PHD in Oakland, CA

Dr Dudleasa Stacie Harris-thomas, PHD is a medicare enrolled "Psychologist - Addiction (substance Use Disorder)" provider in Oakland, California. Her current practice location is 969 Broadway, Oakland, California. You can reach out to her office (for appointments etc.) via phone at (510) 251-3905.

Dr Dudleasa Stacie Harris-thomas is licensed to practice in California (license number PSY17974) 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 1932265170.

Contact Information

	Dr Dudleasa Stacie Harris-thomas, PHD
	969 Broadway, Oakland, CA 94607-4017
	(510) 251-3905
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Dudleasa Stacie Harris-thomas
Gender	Female
Speciality	Psychologist - Addiction (substance Use Disorder)
Location	969 Broadway, Oakland, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1932265170
Provider Enumeration Date: 12/30/2006
Last Update Date: 02/11/2022

Medicare PECOS Information:

PECOS PAC ID: 3779655345
Enrollment ID: I20080626000690

Medical Identifiers

Medical identifiers for Dr Dudleasa Stacie Harris-thomas such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1932265170	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC2200X	Psychologist - Clinical Child & Adolescent	PSY17974 (California)	Primary
103TC0700X	Psychologist - Clinical	PSY17974 (California)	Primary
103TA0400X	Psychologist - Addiction (substance Use Disorder)	PSY17974 (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 Dudleasa Stacie Harris-thomas allows following entities to bill medicare on her behalf.

Entity Name	Permanente Medical Group Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710

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 Dudleasa Stacie Harris-thomas 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
Dr Dudleasa Stacie Harris-thomas, PHD Po Box 20422, Oakland, CA 94620-0422 Ph: (510) 251-3905	Dr Dudleasa Stacie Harris-thomas, PHD 969 Broadway, Oakland, CA 94607-4017 Ph: (510) 251-3905

Reviews and Comments

Psychologist in Oakland, CA

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Nadrienne A Pinnock, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 3301 E 12th St, Oakland, CA 94601 Phone: 510-269-9030

Dr Dudleasa Stacie Harris-thomas, PHD - Medicare Psychologist in Oakland, CA