Katie Bullock, LMFT is a medicare enrolled "Marriage & Family Therapist" provider in Shasta Lake, California. Her current practice location is
5232 Shasta Dam Blvd Ste C, Shasta Lake, California. You can reach out to her office (for appointments etc.) via phone at
(530) 605-4373.
Katie Bullock is licensed to practice in California (license number 106669) 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 1437550498.
Healthcare Provider's Profile
| Full Name | Katie Bullock |
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| Gender | Female |
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| Speciality | Marriage & Family Therapist |
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| Location | 5232 Shasta Dam Blvd Ste C, Shasta Lake, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1437550498
- Provider Enumeration Date: 09/09/2014
- Last Update Date: 05/27/2021
Medicare PECOS Information:
- PECOS PAC ID: 2163839473
- Enrollment ID: I20241029002016
Medical Identifiers
Medical identifiers for Katie Bullock such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1437550498 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 106H00000X | Marriage & Family Therapist | 106669 (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. Katie Bullock 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 |
Katie Bullock, LMFT 5232 Shasta Dam Blvd Ste C, Shasta Lake, CA 96019-9398 Ph: (530) 605-4373 | Katie Bullock, LMFT 5232 Shasta Dam Blvd Ste C, Shasta Lake, CA 96019-9398 Ph: (530) 605-4373 |
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