Julia Tisdale, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

109508 Issued in CA

Practice address

42875 Gatewood St
Fremont, CA 94538-4131

Phone

(510) 656-6438

NPI assigned

Sep 1, 2011

Sex

Female

Sole proprietor

No

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 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

Specialty

Marriage and Family Therapist

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Moona Medical Group of California PCGroup PAC ID 2365955630, 25 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Moona Medical Group of California PC

  • Mental Health Counselor
  • San Francisco, CA
  • NPI 1023824836
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1314835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552435200000",
    "number": "1598046708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6221 GEARY BLVD # US",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941211887",
            "telephone_number": "650-269-9050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42875 GATEWOOD ST",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945384131",
            "telephone_number": "510-656-6438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TISDALE",
        "first_name": "JULIA",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-01",
        "last_updated": "2019-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "109508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arthur J Ting, MEDICAL DOCTOR
• Salvador Tinoco Jaramillo
• Pamela Tint, PT, DPT
• Ruchika Satyanarayan Tirupachur
• Rachel Tischer, IMF
• Catherine Sanda Tjaja
• Melinda To, DPT
• Christina Todaro, M.A.
• Christine Todd, MS, PPS
• Tammy Todd

• Marriage & Family Therapist in Fremont, CA
• Providers in Fremont, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2019; 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.