Taryn Crockerham, LMFT is a medicare enrolled "Marriage & Family Therapist" provider in Santa Clara, California. Her current practice location is
3840 Homestead Rd, Santa Clara, California. You can reach out to her office (for appointments etc.) via phone at
(408) 851-4890.
Taryn Crockerham is licensed to practice in California (license number 106510) 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 1154727121.
Healthcare Provider's Profile
| Full Name | Taryn Crockerham |
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| Gender | Female |
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| Speciality | Marriage & Family Therapist |
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| Location | 3840 Homestead Rd, Santa Clara, 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: 1154727121
- Provider Enumeration Date: 11/18/2014
- Last Update Date: 08/06/2024
Medicare PECOS Information:
- PECOS PAC ID: 7214380195
- Enrollment ID: I20240126002135
Medical Identifiers
Medical identifiers for Taryn Crockerham such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1154727121 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 103T00000X | Psychologist | (* (Not Available)) | Secondary |
| 106H00000X | Marriage & Family Therapist | 106510 (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. Taryn Crockerham allows following entities to bill medicare on her behalf.
| Entity Name | Permanente Medical Group Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1073606299
PECOS PAC ID: 8921910225
Enrollment ID: O20031104000710 |
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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. Taryn Crockerham 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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Taryn Crockerham, LMFT
1346 The Alameda Ste 7,
San Jose, CA 95126-5006
Ph: (408) 851-4890 | Taryn Crockerham, LMFT
3840 Homestead Rd,
Santa Clara, CA 95051-4542
Ph: (408) 851-4890 |
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