Jaclyn Staubach, LCSW in Brea, CA - Medicare Social Worker Provider

Jaclyn Staubach, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Brea, California. Her current practice location is 955 W Imperial Hwy Ste 200, Brea, California. You can reach out to her office (for appointments etc.) via phone at (714) 449-6900.

Jaclyn Staubach is licensed to practice in California (license number LCSW66509) 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 1982057451.

Contact Information

	Jaclyn Staubach, LCSW
	955 W Imperial Hwy Ste 200, Brea, CA 92821-3812
	(714) 449-6900
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Jaclyn Staubach
Gender	Female
Speciality	Social Worker - Clinical
Location	955 W Imperial Hwy Ste 200, Brea, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1982057451
Provider Enumeration Date: 07/19/2016
Last Update Date: 09/22/2022

Medicare PECOS Information:

PECOS PAC ID: 6709262272
Enrollment ID: I20221006001812

Medical Identifiers

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

Identifier	Type	State	Issuer
1982057451	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	LCSW66509 (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 Staubach allows following entities to bill medicare on her behalf.

Entity Name	Providence Medical Foundation
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1285890624 PECOS PAC ID: 8921993205 Enrollment ID: O20040216001346

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 Staubach 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 Staubach, LCSW 955 W Imperial Hwy Ste 200, Brea, CA 92821-3812 Ph: (714) 449-6900	Jaclyn Staubach, LCSW 955 W Imperial Hwy Ste 200, Brea, CA 92821-3812 Ph: (714) 449-6900

Reviews and Comments

Social Worker in Brea, CA

Jasmine Wilson, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 265 S Randolph Ave Ste 185, Brea, CA 92821 Phone: 909-375-9162 Fax: 909-245-2758
Mrs. Monica Cervantes, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 242 S Orange Ave, Brea, CA 92821 Phone: 949-302-8952
Staci Balliet, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1585 Honeywood Ct, Brea, CA 92821 Phone: 714-510-0101
Ms. Patricia Rogers, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3230 E Imperial Hwy, Suite 315, Brea, CA 92821 Phone: 714-524-3799 Fax: 714-528-3416
Dr. Lynn Raine, PHD, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 633 S Brea Blvd Ste 202, Brea, CA 92821 Phone: 714-989-6112
Lili Y Florez, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 242 S Orange Ave, Suite 207, Brea, CA 92821 Phone: 714-292-3244
Thomas Roger Baird, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 149 W Lambert Rd, Brea, CA 92821 Phone: 562-665-7293

Jaclyn Staubach, LCSW - Medicare Clinical Social Worker in Brea, CA