Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jerron Depaul Tatum

Individual provider Marriage & Family Therapist · NPI 1982369468

Jerron Depaul Tatum is a Marriage and Family Therapist in Los Angeles, California. Qualified in 2012, 14 years ago. Practices with Pacific Blue Psychological Services, a 23-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
14
Licensed in
CA
In the registry since
2021
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Practice location Address checks out

990 Villa Street Moutain View Ca
Los Angeles, CA 90043
Phone: (888) 688-9296
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Marriage & Family Therapist (primary) Taxonomy 106H00000X · Licence 133341 (CA)

Record details

NPI number1982369468
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedNovember 1, 2021
Last updated in NPPESJanuary 10, 2025
Certification dateJanuary 7, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMARRIAGE AND FAMILY THERAPIST
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Pacific Blue Psychological Services — 23 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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