ELOISA B DIETRICH – Psychiatric/Mental Health Nurse Practitioner, NPI 1134512288
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
16,353 NURSE PRACTITIONER in CA
Provider Addresses for ELOISA B DIETRICH
425 Diamond Dr Ste 104
Lake Elsinore, CA 925304495
Phone: (516) 744-1149
Type: Location
24703 MONROE AVE STE B
MURRIETA, CA 925629570
Phone: (951) 698-8098
Type: Mailing
30804 HIGHLAND VISTA CIR
TEMECULA, CA 925917264
Phone: (951) 225-8790
Type: Mailing
3835 N FREEWAY BLVD STE 100
SACRAMENTO, CA 958341954
Phone: (916) 576-7900
Type: Mailing
277 RANCHEROS DR STE 301
SAN MARCOS, CA 920692993
Phone: (760) 471-4073
Fax: (760) 471-4078
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 76 Open Payments records for all available years, with a total value of $1,766.
Total Amount is formed as General ($1,766) + Research ($0) + Ownership ($0) = $1,766.
Last reported payment date: 2024-08-05 • Largest payer in this snapshot: Axsome Therapeutics, Inc. ($306).
Total Amount
$1,766
General + Research + Ownership
Payments
76
Total payment records
General Amount
$1,766
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-05
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Axsome Therapeutics, Inc. | $306 |
| ABBVIE INC. | $267 |
| Lundbeck LLC | $211 |
| ITI, Inc. | $188 |
| Bausch Health US, LLC | $148 |
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: 2020-09-15
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20200915000679 | I | Nurse Practitioner | CA | TBD |
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.
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 92530)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| P S Y C H I A T R Y | NY | |
| P S Y C H I A T R Y | CA | |
| Nurse Practitioner | CA | |
| P S Y C H I A T R Y | CA | |
| Nurse Practitioner | CA | |
| P S Y C H I A T R Y | CA | |
| Clinical Psychologist | CA | |
| P S Y C H I A T R Y | CA | |
| P S Y C H I A T R Y | SD | |
| P S Y C H I A T R Y | CA |
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