TRISTAN HOWARD RANDALL – Mental Health Counselor, NPI 1043693369

TRISTAN HOWARD RANDALL is a healthcare provider. based in Moreno valley, California. specializing in CLINICAL SOCIAL WORKER. They hold a License No. 104413 (CA). The NPI Number for TRISTAN HOWARD RANDALL is 1043693369

Main info

Male
Sole Proprietor
8 Years Of Experience
Accepts Medicare Assignment
Name
TRISTAN HOWARD RANDALL
NPI
1043693369
Phone
(951) 202-5012
Address
26371 THOROUGHBRED LN
Enumeration Date
6 July 2015
Last Update Date
23 January 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4423279311
Graduation Year
2018 (8 years ago)
PAC ID
9830584721
Group Practice PAC ID
2860819125
Professional Enrollment ID
I20220310002359
Address ID
CA923922910VI15497STXX400
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience49
Completeness75
Years active:10State licenses:1Digital endpointsOther names

4,987 CLINICAL SOCIAL WORKER in CA

Provider Addresses for TRISTAN HOWARD RANDALL

  • 26371 THOROUGHBRED LN

    MORENO VALLEY, CA 925552927

    Phone: (951) 202-5012

    Type: Mailing

  • 3075 MYERS ST

    RIVERSIDE, CA 925035525

    Phone: (951) 955-7108

    Fax: (951) 955-7205

    Type: Location

  • 15497 W SAND ST

    VICTORVILLE, CA 923922910

    Phone: (442) 327-9311

    Fax: (442) 327-9315

    Type: Mailing

  • 29995 TECHNOLOGY DR STE 306

    MURRIETA, CA 925632634

    Phone: (442) 327-9311

    Fax: (442) 327-9315

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-03-10

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220310002359IClinical Social WorkerCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 92555)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2860819125View full group profile
NameSpecialtyState
Marriage And Family TherapistCA
Mental Health CounselorCA
Clinical Social WorkerCA
Clinical Social WorkerCA
Clinical Social WorkerCA
Clinical Social WorkerCA
Clinical Social WorkerCA
Marriage And Family TherapistCA
Marriage And Family TherapistCA
Clinical Social WorkerCA

Reviews

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Frequently asked questions

Can I cross-check TRISTAN HOWARD RANDALL using NPI 1043693369?
NPI 1043693369 belongs to TRISTAN HOWARD RANDALL; compare other details if you need extra assurance.
Is TRISTAN HOWARD RANDALL still an active registrant?
TRISTAN HOWARD RANDALL carries an active NPI according to the public dataset.
What clinical focus is listed for TRISTAN HOWARD RANDALL?
At a glance, TRISTAN HOWARD RANDALL is tied to Mental Health Counselor. Clinical services aligned with this taxonomy classification.
Is TRISTAN HOWARD RANDALL associated with Moreno Valley?
Public fields place TRISTAN HOWARD RANDALL around Moreno Valley, California. Always confirm the exact site before visiting.
What does 4 location(s) imply?
4 practice locations appear in the available data.

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