Tucker Peck, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

4688 Issued in AZ

Practice address

2103 San Jose Ave
Alameda, CA 94501-4994

Phone

(520) 485-9411

Fax

(844) 227-8699

NPI assigned

Dec 15, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ, CA2 enrollments

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 2

Specialty

Clinical Psychologist

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Mahnamana Psychotherapy and Meditation

  • Psychologist
  • Alameda, CA
  • NPI 1841951399
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1450137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667347200000",
    "number": "1205291440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2103 SAN JOSE AVE UNIT C",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945014994",
            "telephone_number": "520-485-9411",
            "fax_number": "844-227-8699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2103 SAN JOSE AVE",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945014994",
            "telephone_number": "520-485-9411",
            "fax_number": "844-227-8699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "TUCKER",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-12-15",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "4688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kennedy Alysse Patti
• Cheryl-Grace Elizabeth Patty, PSY.D
• Joshua Paulos, LCSW96230
• Monica Ann Payumo
• Pearle Visioncare, Inc
• Nina Peele
• Gianna Micol Pellettieri, DPT
• Julio Cesar Pena
• Marisol Pena
• Cameron Scott Penta, DC

• Clinical Psychologist in Alameda, CA
• Providers in Alameda, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.