Ryecobie Brooks-gordon, is a medicare enrolled "Psychologist" provider in Chowchilla, California. Her current practice location is
21633 Avenue 24, Chowchilla, California. You can reach out to her office (for appointments etc.) via phone at
(559) 665-6100.
Ryecobie Brooks-gordon is licensed to practice in California (license number PSY32075) 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 1427452044.
Healthcare Provider's Profile
| Full Name | Ryecobie Brooks-gordon |
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| Gender | Female |
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| Speciality | Psychologist |
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| Location | 21633 Avenue 24, Chowchilla, 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: 1427452044
- Provider Enumeration Date: 10/09/2014
- Last Update Date: 05/21/2024
Medicare PECOS Information:
- PECOS PAC ID: 1355747221
- Enrollment ID: I20210901003065
Medical Identifiers
Medical identifiers for Ryecobie Brooks-gordon such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1427452044 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 103T00000X | Psychologist | (* (Not Available)) | Secondary |
| 103TC0700X | Psychologist - Clinical | PSY32075 (California) | Secondary |
| 103TC0700X | Psychologist - Clinical | 38863 (Texas) | Secondary |
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Secondary |
| 103T00000X | Psychologist | PSY32075 (California) | Primary |
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. Ryecobie Brooks-gordon 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 |
|---|
Ryecobie Brooks-gordon,
Po Box 5964,
Fresno, CA 93755-5964
Ph: () - | Ryecobie Brooks-gordon,
21633 Avenue 24,
Chowchilla, CA 93610-9650
Ph: (559) 665-6100 |
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