Jessica Kiesendahl, MFT in San Dimas, CA - Medicare Marriage & Family Therapist Provider

Jessica Kiesendahl, MFT is a medicare enrolled "Marriage & Family Therapist" provider in San Dimas, California. Her current practice location is 762 W Cypress Ave, San Dimas, California. You can reach out to her office (for appointments etc.) via phone at (909) 599-1227.

Jessica Kiesendahl is licensed to practice in California (license number 80216) 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 1790817682.

Contact Information

	Jessica Kiesendahl, MFT
	762 W Cypress Ave, San Dimas, CA 91773-3505
	(909) 599-1227
	(909) 599-4157

Map and Direction

Healthcare Provider's Profile

Full Name	Jessica Kiesendahl
Gender	Female
Speciality	Marriage & Family Therapist
Location	762 W Cypress Ave, San Dimas, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1790817682
Provider Enumeration Date: 03/09/2007
Last Update Date: 12/09/2024

Medicare PECOS Information:

PECOS PAC ID: 1658807656
Enrollment ID: I20241213003379

Medical Identifiers

Medical identifiers for Jessica Kiesendahl such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1790817682	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	(* (Not Available))	Secondary
106H00000X	Marriage & Family Therapist	80216 (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. Jessica Kiesendahl 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. Jessica Kiesendahl 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
Jessica Kiesendahl, MFT 762 W Cypress Ave, San Dimas, CA 91773-3505 Ph: (909) 599-1227	Jessica Kiesendahl, MFT 762 W Cypress Ave, San Dimas, CA 91773-3505 Ph: (909) 599-1227

Reviews and Comments

Marriage & Family Therapist in San Dimas, CA

Kelly Little, LMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 100 W Foothill Blvd Ste 104, San Dimas, CA 91773 Phone: 626-603-8396 Fax: 626-413-3423
Dr. Roswitha M Brooks, PHD Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 1173 N Dixie Dr Ste 101, San Dimas, CA 91773 Phone: 909-599-8189
Monique Gutierrez, Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 180 Via Verde, San Dimas, CA 91773 Phone: 909-599-1227
Ms. Angela Marie Castellanos, LMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 100 W Foothill Blvd Ste 103, San Dimas, CA 91773 Phone: 909-296-9694
Candice Venessa Cabrera, Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 762 Cypress St, San Dimas, CA 91773 Phone: 909-599-1227
Evelyn Oregel, Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 180 Via Verde Ste 200, San Dimas, CA 91773 Phone: 909-599-1227
Rosemary Jacqueline Garcia, Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 762 Cypress St, San Dimas, CA 91773 Phone: 909-599-1227

Jessica Kiesendahl, MFT - Medicare Couples Therapy in San Dimas, CA