Individual provider Active NPI

Joy Elaine Tennant, M.A.

  • Marriage & Family Therapist
  • Red Bluff, CA
National Provider Identifier
1104014356
Registry record updated Jun 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
50367 Issued in CA
Practice address
590 Antelope Blvd Ste 40a
Red Bluff, CA 96080-2477
Phone
(530) 529-9454
Fax
(530) 529-9456
NPI assigned
Oct 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 50367 CA Primary

Addresses

Primary practice location

590 Antelope Blvd Ste 40a
Red Bluff, CA 96080-2477

Mailing address

PO Box 950
Red Bluff, CA 96080-0950
Phone (530) 529-9454

Other identifiers 1

IdentifierTypeStateIssuer
1104014356OtherCANPI

Other names 1

  • Joy Elaine Tennant Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL 530-529-9456

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240509003108 CA Practitioner - Marriage and Family Therapist 6507202652 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Karuk TribeGroup PAC ID 4688668387, 11 clinicians

Practice addresses (Care Compare)

1515 S Oregon St
Yreka, CA 96097-3475
Phone 53084131412108

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Karuk Tribe CurrentSince Jan 14, 2024 Accepting new patients
His Ideas, Inc CurrentSince Oct 29, 2023 Accepting new patients
His Ideas, Inc CurrentSince Jun 27, 2021 Accepting new patients
Karuk Tribe CurrentSince Jan 14, 2024 Accepting new patients

Locations

590 Antelope Blvd
Ste 40A
Red Bluff, CA 96080
Phone (530) 529-9454

1515 S Oregon St
Yreka, CA 96097
Phone (530) 841-1783

1519 S Oregon St
Yreka, CA 96097
Phone (530) 842-9200

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624579200000",
    "number": "1104014356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 950",
            "city": "RED BLUFF",
            "state": "CA",
            "postal_code": "960800950",
            "telephone_number": "530-529-9454",
            "fax_number": "530-529-9456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 ANTELOPE BLVD STE 40A",
            "city": "RED BLUFF",
            "state": "CA",
            "postal_code": "960802477",
            "telephone_number": "530-529-9454",
            "fax_number": "530-529-9456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENNANT",
        "first_name": "JOY",
        "middle_name": "ELAINE",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-11",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "50367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1104014356",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "530-529-9456",
            "affiliation": "N",
            "endpointDescription": "Fax",
            "address_1": "590 Antelope Blvd Ste 40A",
            "city": "Red Bluff",
            "state": "CA",
            "country_code": "US",
            "postal_code": "960802477",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JOY",
            "last_name": "TENNANT",
            "middle_name": "ELAINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Red Bluff, CA

Sources for this page

Verify at the official NPI Registry.