Ida Lucille Whitaker

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

100567 Issued in CA

Practice address

1002 E Grand Ave
Escondido, CA 92025-4605

Phone

(760) 741-2660

Fax

(760) 741-2647

NPI assigned

Jun 4, 2018

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 MT

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Center for Mental HealthGroup PAC ID 3072416676, 13 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.

• Center for Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Great Falls, MT
  • NPI 1144251885

  Marriage & Family Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1528070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528070400000",
    "number": "1962994038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 ALLISON LN",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920696516",
            "telephone_number": "619-454-0602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 E GRAND AVE",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920254605",
            "telephone_number": "760-741-2660",
            "fax_number": "760-741-2647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITAKER",
        "first_name": "IDA",
        "middle_name": "LUCILLE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-04",
        "last_updated": "2018-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "100567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Micheal Weuste, LCSW
• Charissa Nicole Whaley
• Stewart Whang, DDS
• Alisa Renee Whelchel
• Anita Mohan Whitaker
• Annie P White, MSTOM, L.AC.
• David Richard White, CADC II- ICADC
• Deja Aman White
• Jennie White
• Joshua Alan White, PA-C

• Marriage & Family Therapist in Escondido, CA
• Providers in Escondido, 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 Jun 4, 2018; 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.