ELOISA B DIETRICH
NPI 1134512288
Nurse Practitioner - Psychiatric/Mental Health in San Marcos, CA

Q: What is Eloisa Dietrich's NPI number?

The NPI number for Eloisa Dietrich is 1134512288. It was assigned to this individual provider in the NPPES registry on March 13, 2015.

Q: What is Eloisa Dietrich's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Eloisa Dietrich was last updated on May 24, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 13, 2015PECOS EnrolledAccepts Medicare Assignment

277 RANCHEROS DR STE 301, SAN MARCOS, CA 92069(760) 471-4073(760) 471-4078 Get Directions Write a Review

NPPES record last updated: May 24, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 19, 2023, Jan 6, 2021 (2 updates tracked since 2021).

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About Eloisa B Dietrich NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ELOISA B DIETRICH (NPI 1134512288) is an individual psychiatric/mental health provider in San Marcos, California, licensed in California (363LFOOOOX) and active in the NPI registry since March 2015. She is enrolled in Medicare PECOS, maintains a secondary practice location in Lake Elsinore, and is a graduate of Other (2012).

NPPES Registry Identity

NPI1134512288

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameELOISA B DIETRICH

Location Address277 RANCHEROS DR STE 301San Marcos, CA 92069-2993

Mailing Address3835 N Freeway Blvd Ste 100Sacramento, CA 95834-1954 · (916) 576-7900

Phone(760) 471-4073

Fax(760) 471-4078

Sole ProprietorNo

Medical School CMSOtherGraduated 2012

Enumeration DateMarch 13, 2015

Last NPPES UpdateMay 24, 20242 updates tracked since enumeration

NPPES CertifiedMay 24, 2024

✔ NPI 1134512288 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in CA · 363LFOOOOX

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 95001871 (CA)

277 RANCHEROS DR STE 301, San Marcos, CA 92069

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Secondary Practice Location 1

Location 1425 Diamond Dr Ste 104Lake Elsinore, CA 92530-4495 · Phone (516) 744-1149

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Eloisa B Dietrich is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1153749783

PECOS Enrollment IDI20200915000679

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92069 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$94.87 typical visit price

range $62.10 – $184.71

Typical copayment $23.71 (range $15.52 – $46.17)

Most-billed visit code 99203

Established Patient

$108.42 typical visit price

range $20.62 – $151.42

Typical copayment $27.10 (range $5.15 – $37.85)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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Other Providers at the Same Location NPPES 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KEVIN BARR MFT

Marriage & Family Therapist