Johanna Christine Walthall, PHD in Costa Mesa, CA - Medicare Psychologist Provider

Johanna Christine Walthall, PHD is a medicare enrolled "Psychologist - Clinical" provider in Costa Mesa, California. Her current practice location is 180 Cabrillo St Apt B19, Costa Mesa, California. You can reach out to her office (for appointments etc.) via phone at (562) 234-7568.

Johanna Christine Walthall is licensed to practice in California (license number PSY21948) 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 1750604583.

Contact Information

	Johanna Christine Walthall, PHD
	180 Cabrillo St Apt B19, Costa Mesa, CA 92627-3051
	(562) 234-7568
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Johanna Christine Walthall
Gender	Female
Speciality	Psychologist - Clinical
Location	180 Cabrillo St Apt B19, Costa Mesa, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1750604583
Provider Enumeration Date: 03/08/2010
Last Update Date: 12/06/2021

Medicare PECOS Information:

PECOS PAC ID: 1456591437
Enrollment ID: I20130716000468

Medical Identifiers

Medical identifiers for Johanna Christine Walthall such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1750604583	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC0700X	Psychologist - Clinical	PSY21948 (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. Johanna Christine Walthall allows following entities to bill medicare on her behalf.

Entity Name	Southern California Permanente Medical Group
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1316979834 PECOS PAC ID: 6002729175 Enrollment ID: O20040126000823

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. Johanna Christine Walthall 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
Johanna Christine Walthall, PHD 17046 Marygold Ave, Fontana, CA 92335-1722 Ph: (909) 427-6705	Johanna Christine Walthall, PHD 180 Cabrillo St Apt B19, Costa Mesa, CA 92627-3051 Ph: (562) 234-7568

Reviews and Comments

Psychologist in Costa Mesa, CA

Kyle P. Jones, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1102 Valley Cir, Costa Mesa, CA 92627 Phone: 949-244-3184
Bobbie Mcdonald, PSY.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 181 E 18th St, Ste B, Costa Mesa, CA 92627 Phone: 949-887-9616
Dr. Erik J Abell, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 151 Kalmus Dr, Suite B220, Costa Mesa, CA 92626 Phone: 949-675-0545 Fax: 714-437-1687
Ms. Elizabeth Lee Waterman, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 652 Beach St, Costa Mesa, CA 92627 Phone: 949-836-5634
Mary Ann Armanious, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 940 S Coast Dr Ste 225, Costa Mesa, CA 92626 Phone: 949-743-1457
Dr. Jay Gattis, PSY.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 2900 Bristol St, Ste A108, Costa Mesa, CA 92626 Phone: 714-432-0042 Fax: 714-432-0049
Mira Makar, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 940 S Coast Dr, Costa Mesa, CA 92626 Phone: 949-743-1457

Johanna Christine Walthall, PHD - Medicare Psychologist in Costa Mesa, CA