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DEITRA DEAN MCMAHON
NPI 1780204842
Counselor in Santa Cruz, CA

Active since April 19, 2020PECOS Enrolled
700 FREDERICK ST STE C, SANTA CRUZ, CA 95062(831) 996-1222 Get Directions Write a Review

NPPES record last updated: April 19, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Deitra Dean Mcmahon NPPES

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

DEITRA DEAN MCMAHON (NPI 1780204842) is an individual counselor in Santa Cruz, California, licensed in California (ASW85759) and active in the NPI registry since April 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1780204842
Entity TypeIndividualFemale
Primary Taxonomy101Y00000X
Provider Legal NameDEITRA DEAN MCMAHON
Location Address700 FREDERICK ST STE CSanta Cruz, CA 95062-2239
Mailing AddressPo Box 7691Santa Cruz, CA 95061-7691
Phone(831) 996-1222
Sole ProprietorYes
Enumeration DateApril 19, 2020
NPPES CertifiedApril 19, 2020
✔ NPI 1780204842 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
License✔ Licensed in CA · ASW85759
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
700 FREDERICK ST STE C, Santa Cruz, CA 95062
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Deitra Dean Mcmahon is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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 Deitra Mcmahon's NPI number?

The NPI number for Deitra Mcmahon is 1780204842. It was assigned to this individual provider in the NPPES registry on April 19, 2020.

Where is Deitra Mcmahon located?

Deitra Mcmahon practices at 700 Frederick St Ste C, Santa Cruz, CA 95062. The listed phone number is (831) 996-1222.

What is Deitra Mcmahon's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Is Deitra Mcmahon enrolled in Medicare?

Yes. Deitra Mcmahon is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Deitra Mcmahon was last updated on April 19, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.