Jaclyn Long, MFT in Los Altos, CA - Medicare Marriage & Family Therapist Provider

Jaclyn Long, MFT is a medicare enrolled "Marriage & Family Therapist" provider in Los Altos, California. Her current practice location is 851 Fremont Ave, Los Altos, California. You can reach out to her office (for appointments etc.) via phone at (650) 297-3400.

Jaclyn Long is licensed to practice in California (license number 47100) 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 1871065961.

Contact Information

	Jaclyn Long, MFT
	851 Fremont Ave, Los Altos, CA 94024-5698
	(650) 297-3400
	(650) 897-1005

Map and Direction

Healthcare Provider's Profile

Full Name	Jaclyn Long
Gender	Female
Speciality	Marriage & Family Therapist
Location	851 Fremont Ave, Los Altos, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1871065961
Provider Enumeration Date: 12/30/2018
Last Update Date: 12/03/2023

Medicare PECOS Information:

PECOS PAC ID: 0648621763
Enrollment ID: I20240112001585

Medical Identifiers

Medical identifiers for Jaclyn Long such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1871065961	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
106H00000X	Marriage & Family Therapist	47100 (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. Jaclyn Long allows following entities to bill medicare on her behalf.

Entity Name	Mindful Child & Family Therapy Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1780156877 PECOS PAC ID: 8820449945 Enrollment ID: O20240112001347

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. Jaclyn Long 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
Jaclyn Long, MFT Po Box 3156, Half Moon Bay, CA 94019-3156 Ph: (415) 533-8012	Jaclyn Long, MFT 851 Fremont Ave, Los Altos, CA 94024-5698 Ph: (650) 297-3400

Reviews and Comments

Marriage & Family Therapist in Los Altos, CA

Kristina Peterson, MFT Couples Therapy Medicare: Medicare Enrolled Practice Location: 851 Fremont Ave Ste 103, Los Altos, CA 94024 Phone: 650-906-0613
Lacona Woltmon, LMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 4546 El Camino Real Ste 242, Los Altos, CA 94022 Phone: 650-397-1062
Mary Tsai, LMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 354 Verano Dr, Los Altos, CA 94022 Phone: 650-948-8098
Gian Michael Sarabia, Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 1427 Miramonte Ave, Los Altos, CA 94024 Phone: 669-977-2290
Claire Victoria Thomas, LMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 881 Fremont Ave Ste B7, Los Altos, CA 94024 Phone: 650-458-7111
Pamela Sturner, LMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 881 Fremont Ave Ste B7, Los Altos, CA 94024 Phone: 408-940-5131
Ilana Sharaun, M.F.T Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 288 Quinnhill Ave, Los Altos, CA 94024 Phone: 650-996-3362 Fax: 650-949-3446

Jaclyn Long, MFT - Medicare Couples Therapy in Los Altos, CA