Heather Pedersen, PHD is a medicare enrolled "Clinical Neuropsychologist" provider in Clovis, California. She graduated from medical school in 2012 and has 12 years of diverse experience with area of expertise as Clinical Psychologist. Her current practice location is
264 Clovis Ave # 104, Clovis, California. You can reach out to her office (for appointments etc.) via phone at
(559) 777-9061.
Heather Pedersen is licensed to practice in California (license number PSY31209) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1083032635.
Healthcare Provider's Profile
| Full Name | Heather Pedersen |
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| Gender | Female |
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| Speciality | Clinical Psychologist |
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| Experience | 12 Years |
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| Location | 264 Clovis Ave # 104, Clovis, California |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Heather Pedersen graduated from medical school in 2012
NPI Data:
- NPI Number: 1083032635
- Provider Enumeration Date: 04/01/2014
- Last Update Date: 04/21/2021
Medicare PECOS Information:
- PECOS PAC ID: 1658596317
- Enrollment ID: I20191114000119
Medical Identifiers
Medical identifiers for Heather Pedersen such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1083032635 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 103TA0700X | Psychologist - Adult Development & Aging | PSY31209 (California) | Secondary |
| 103TB0200X | Psychologist - Cognitive & Behavioral | PSY31209 (California) | Secondary |
| 103TC0700X | Psychologist - Clinical | PSY31209 (California) | Secondary |
| 103TM1800X | Psychologist - Intellectual & Developmental Disabilities | PSY31209 (California) | Secondary |
| 103TR0400X | Psychologist - Rehabilitation | PSY31209 (California) | Secondary |
| 103G00000X | Clinical Neuropsychologist | PSY31209 (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. Heather Pedersen allows following entities to bill medicare on her behalf.
| Entity Name | Community Foundation Medical Group |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1811258510
PECOS PAC ID: 0345406294
Enrollment ID: O20120723000387 |
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| Entity Name | Doctor On Demand Professionals Of California |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1346658614
PECOS PAC ID: 6406161538
Enrollment ID: O20180216001603 |
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| Entity Name | Pacific Stone Psychology Corporation |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1770167371
PECOS PAC ID: 9830599844
Enrollment ID: O20210614001061 |
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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. Heather Pedersen 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 |
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Heather Pedersen, PHD
264 Clovis Avenue #104, 264 Clovis Avenue #104,
Clovis, CA 93612
Ph: (559) 777-9061 | Heather Pedersen, PHD
264 Clovis Ave # 104,
Clovis, CA 93612-1115
Ph: (559) 777-9061 |
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