Jennifer A Clark, LCSW in Petaluma, CA - Medicare Social Worker Provider

Jennifer A Clark, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Petaluma, California. Her current practice location is 1301 Southpoint Blvd, Petaluma, California. You can reach out to her office (for appointments etc.) via phone at (707) 559-7500.

Jennifer A Clark is licensed to practice in California (license number ASW19290) 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 1770893786.

Contact Information

	Jennifer A Clark, LCSW
	1301 Southpoint Blvd, Petaluma, CA 94954-6867
	(707) 559-7500
	(707) 559-7540

Map and Direction

Healthcare Provider's Profile

Full Name	Jennifer A Clark
Gender	Female
Speciality	Social Worker - Clinical
Location	1301 Southpoint Blvd, Petaluma, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1770893786
Provider Enumeration Date: 10/13/2010
Last Update Date: 12/30/2021

Medicare PECOS Information:

PECOS PAC ID: 1850612540
Enrollment ID: I20150605002453

Medical Identifiers

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

Identifier	Type	State	Issuer
1770893786	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	ASW19290 (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. Jennifer A 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. Jennifer A 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
Jennifer A Clark, LCSW 1301 Southpoint Blvd, Petaluma, CA 94954-6867 Ph: (707) 559-7500	Jennifer A Clark, LCSW 1301 Southpoint Blvd, Petaluma, CA 94954-6867 Ph: (707) 559-7500

Reviews and Comments

Social Worker in Petaluma, CA

Ms. Judy B Iwanier, MSW, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 5 Keller St, # 2, Petaluma, CA 94952 Phone: 310-423-0736
Lorena Yanez-ramirez, ACSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1179 N Mcdowell Blvd, Petaluma, CA 94954 Phone: 707-559-7500
Mayra Gonzalez, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 1179 N Mcdowell Blvd, Petaluma, CA 94954 Phone: 707-559-7500 Fax: 707-559-7620
Mr. Robert O Butler, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 40 4th St Ste 224, Petaluma, CA 94952 Phone: 707-241-3003
Rebecca A Stanwyck, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: Po Box 2511, Petaluma, CA 94953 Phone: 510-881-2540
Marilyn Lee Jaffe, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 508 West St, Petaluma, CA 94952 Phone: 707-318-3912
Ms. Patricia Sue Yardley, Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 7 4th St, Ste 62, Petaluma, CA 94952 Phone: 503-853-6847

Jennifer A Clark, LCSW - Medicare Clinical Social Worker in Petaluma, CA