Dr Jacqueline Raines-kohler, PSYD is a medicare enrolled "Psychologist - Clinical" provider in Vallejo, California. Her current practice location is
1761 Broadway St Ste 100, Vallejo, California. You can reach out to her office (for appointments etc.) via phone at
(707) 645-2700.
Dr Jacqueline Raines-kohler is licensed to practice in California (license number 26289) 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 1104050897.
Healthcare Provider's Profile
Full Name | Dr Jacqueline Raines-kohler |
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Gender | Female |
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Speciality | Psychologist - Clinical |
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Location | 1761 Broadway St Ste 100, Vallejo, California |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1104050897
- Provider Enumeration Date: 05/08/2009
- Last Update Date: 01/11/2022
Medicare PECOS Information:
- PECOS PAC ID: 3870811938
- Enrollment ID: I20150421002521
Medical Identifiers
Medical identifiers for Dr Jacqueline Raines-kohler such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1104050897 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
103TC0700X | Psychologist - Clinical | 26289 (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 Jacqueline Raines-kohler allows following entities to bill medicare on her behalf.
Entity Name | Permanente Medical Group Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710 |
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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. Dr Jacqueline Raines-kohler 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 Jacqueline Raines-kohler, PSYD 1761 Broadway St Ste 100, Vallejo, CA 94589-2227 Ph: () - | Dr Jacqueline Raines-kohler, PSYD 1761 Broadway St Ste 100, Vallejo, CA 94589-2227 Ph: (707) 645-2700 |
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