MRS. TYESHA T SULLIVAN LMFT
NPI 1871246462
Marriage & Family Therapist in Stockton, CA
About Mrs. Tyesha T Sullivan Lmft NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. TYESHA T SULLIVAN LMFT (NPI 1871246462) is an individual marriage & family therapist in Stockton, California, licensed in California (123866) and active in the NPI registry since February 2022. She is enrolled in Medicare PECOS and maintains a secondary practice location in Stockton.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mrs. Tyesha T Sullivan Lmft is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Tyesha Sullivan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
San Jose, CA 95113
- Reassigned Medicare billing, California enrollment
- 3,139 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 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
STOCKTON, CA 95202
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 Tyesha Sullivan's NPI number?
The NPI number for Tyesha Sullivan is 1871246462. It was assigned to this individual provider in the NPPES registry on February 2, 2022.
Where is Tyesha Sullivan located?
Tyesha Sullivan practices at 540 N California St, Stockton, CA 95202. The listed phone number is (209) 464-4524.
What is Tyesha Sullivan's specialty?
The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.
Is Tyesha Sullivan enrolled in Medicare?
Yes. Tyesha Sullivan is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Tyesha Sullivan's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Tyesha Sullivan reassigns Medicare benefits to Grow Healthcare Group PC (San Jose, 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 Tyesha Sullivan'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 Tyesha Sullivan was last updated on August 8, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Mrs. Tyesha T Sullivan, LMFT · NPI 1871246462
Marriage & Family Therapist provider in Stockton, California. Individual provider, active in the CMS NPPES registry since February 2, 2022.
## Identity
- **NPI:** 1871246462 (Entity type: Individual)
- **Enumerated:** February 2, 2022
- **Primary specialty:** Marriage & Family Therapist · taxonomy 106H00000X
- **State license:** 123866 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 540 N CALIFORNIA ST, Stockton, CA 95202-2117
- **Phone:** (209) 464-4524
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Grow Healthcare Group PC (NPI 1154994846, San Jose, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 8, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1871246462) · Data from the CMS NPPES public registry.