MARY LIGHTHOLDER
NPI 1003068966
Counselor - Mental Health in San Leandro, CA
About Mary Lightholder NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARY LIGHTHOLDER (NPI 1003068966) is an individual mental health provider in San Leandro, California and active in the NPI registry since October 2008. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mary Lightholder is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Mary Lightholder reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Palo Alto, CA 94306
- Reassigned Medicare billing, California enrollment
- Also billed through NPI 1043354020 (California), NPI 1629301346 (California)
- 2,460 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Mary Lightholder's NPI number?
The NPI number for Mary Lightholder is 1003068966. It was assigned to this individual provider in the NPPES registry on October 22, 2008.
Where is Mary Lightholder located?
Mary Lightholder practices at 500 Davis St, San Leandro, CA 94577. The listed phone number is (510) 618-6428.
What is Mary Lightholder's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Mary Lightholder enrolled in Medicare?
Yes. Mary Lightholder is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Mary Lightholder's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mary Lightholder reassigns Medicare benefits to County Of Santa Clara (Palo Alto, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mary Lightholder's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Mary Lightholder was last updated on August 30, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mary Lightholder · NPI 1003068966
Mental Health provider in San Leandro, California. Individual provider, active in the CMS NPPES registry since October 22, 2008.
## Identity
- **NPI:** 1003068966 (Entity type: Individual)
- **Enumerated:** October 22, 2008
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **Sole proprietor:** No
## Practice location
- **Address:** 500 DAVIS ST, San Leandro, CA 94577-2757
- **Phone:** (510) 618-6428
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** County Of Santa Clara (NPI 1285228080, Palo Alto, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 30, 2012
---
Source: [NPI Profile](https://npiprofile.com/npi/1003068966) · Data from the CMS NPPES public registry.