Jacqueline Marie Fajardo, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Dublin, California. Her current practice location is
5601 Arnold Rd Ste 200, Dublin, California. You can reach out to her office (for appointments etc.) via phone at
(925) 440-4593.
Jacqueline Marie Fajardo is licensed to practice in California (license number 87322) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1215342118.
Healthcare Provider's Profile
Full Name | Jacqueline Marie Fajardo |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 5601 Arnold Rd Ste 200, Dublin, California |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1215342118
- Provider Enumeration Date: 06/30/2014
- Last Update Date: 03/01/2022
Medicare PECOS Information:
- PECOS PAC ID: 8325471907
- Enrollment ID: I20191212001638
Medical Identifiers
Medical identifiers for Jacqueline Marie Fajardo such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1215342118 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | 72017 (California) | Secondary |
1041C0700X | Social Worker - Clinical | 87322 (California) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jacqueline Marie Fajardo allows following entities to bill medicare on her behalf.
Entity Name | Family Health Centers Of San Diego, Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1447281936 PECOS PAC ID: 3476446378 Enrollment ID: O20040204000923 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jacqueline Marie Fajardo is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Jacqueline Marie Fajardo, LCSW 5601 Arnold Rd Ste 200, Dublin, CA 94568-7724 Ph: () - | Jacqueline Marie Fajardo, LCSW 5601 Arnold Rd Ste 200, Dublin, CA 94568-7724 Ph: (925) 440-4593 |
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