Mrs Deatria Davis, in San Mateo, CA - Medicare Counselor Provider

Mrs Deatria Davis, is a medicare enrolled "Counselor - Mental Health" provider in San Mateo, California. Her current practice location is 2600 S. El Camino Real, San Mateo, California. You can reach out to her office (for appointments etc.) via phone at (209) 752-1965.

Mrs Deatria Davis is licensed to practice in * (Not Available) (license number ) 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 1659641835.

Contact Information

	Mrs Deatria Davis,
	2600 S. El Camino Real, San Mateo, CA 94403
	(209) 752-1965
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Mrs Deatria Davis
Gender	Female
Speciality	Counselor - Mental Health
Location	2600 S. El Camino Real, San Mateo, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1659641835
Provider Enumeration Date: 01/05/2012
Last Update Date: 07/20/2015

Medicare PECOS Information:

PECOS PAC ID: 6901342153
Enrollment ID: I20240723004842

Medical Identifiers

Medical identifiers for Mrs Deatria Davis such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1659641835	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	(* (Not Available))	Primary
106H00000X	Marriage & Family Therapist	(* (Not Available))	Secondary
171M00000X	Case Manager/care Coordinator	(* (Not Available))	Secondary
390200000X	Student In An Organized Health Care Education/training Program	(* (Not Available))	Secondary

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. Mrs Deatria Davis allows following entities to bill medicare on her behalf.

Entity Name	Wk Medical Group
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1588083992 PECOS PAC ID: 6103116348 Enrollment ID: O20160601000362

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. Mrs Deatria Davis 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
Mrs Deatria Davis, 231 Gee Gee Ave, Los Banos, CA 93635-3278 Ph: (209) 752-1965	Mrs Deatria Davis, 2600 S. El Camino Real, San Mateo, CA 94403 Ph: (209) 752-1965

Reviews and Comments

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Mrs Deatria Davis, - Medicare Counselor in San Mateo, CA