Dr Jennifer Clark, PSYD in Cupertino, CA - Medicare Psychologist Provider

Dr Jennifer Clark, PSYD is a medicare enrolled "Psychologist - Clinical" provider in Cupertino, California. Her current practice location is 19000 Homestead Rd, Bldg. 2, Floor 1, Cupertino, California. You can reach out to her office (for appointments etc.) via phone at (408) 366-4463.

Dr Jennifer Clark is licensed to practice in California (license number 28626) 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 1396289666.

Contact Information

	Dr Jennifer Clark, PSYD
	19000 Homestead Rd, Bldg. 2, Floor 1, Cupertino, CA 95014-0712
	(408) 366-4463
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Jennifer Clark
Gender	Female
Speciality	Psychologist - Clinical
Location	19000 Homestead Rd, Cupertino, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1396289666
Provider Enumeration Date: 12/06/2016
Last Update Date: 01/03/2022

Medicare PECOS Information:

PECOS PAC ID: 7810278801
Enrollment ID: I20170105002276

Medical Identifiers

Medical identifiers for Dr Jennifer Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1396289666	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC0700X	Psychologist - Clinical	28626 (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. Dr Jennifer Clark allows following entities to bill medicare on her behalf.

Entity Name	Permanente Medical Group Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710

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. Dr Jennifer Clark 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
Dr Jennifer Clark, PSYD 19000 Homestead Rd, Bldg. 2, Floor 1, Cupertino, CA 95014-0712 Ph: (408) 366-4463	Dr Jennifer Clark, PSYD 19000 Homestead Rd, Bldg. 2, Floor 1, Cupertino, CA 95014-0712 Ph: (408) 366-4463

Reviews and Comments

Psychologist in Cupertino, CA

Dr. Roger Johnson, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 19000 Homestead Rd, Cupertino, CA 95014 Phone: 408-366-4408 Fax: 408-366-4405
Dr. Steven Aldo Del Chiaro, PSYD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 20833 Stevens Creek Blvd Suite 100, Cupertino, CA 95014 Phone: 408-342-0160
Dr. Julia Beth Hadricky, PSY.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 19000 Homestead Rd, Cupertino, CA 95014 Phone: 813-382-4844
Priya Mahurkar, PH.D. Psychologist Medicare: Accepting Medicare Assignments Practice Location: 20833 Stevens Creek Blvd, Suite 100, Cupertino, CA 95014 Phone: 408-342-0612 Fax: 408-342-0617
Dr. Catherine Mary Marino, PSY.D. Psychologist Medicare: Medicare Enrolled Practice Location: 19000 Homestead Rd, Building 2, Psychiatry Administration Suite, Cupertino, CA 95014 Phone: 650-283-9334
Dr. Martin Howard Williams, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 19000 Homestead Rd, Cupertino, CA 95014 Phone: 408-366-4409
Matthew Tarran, PH.D. Psychologist Medicare: Medicare Enrolled Practice Location: 19000 Homestead Rd, Cupertino, CA 95014 Phone: 408-366-4215 Fax: 408-366-4201

Dr Jennifer Clark, PSYD - Medicare Psychologist in Cupertino, CA