JENNIFER M. CLARK R.N. FNP PMHNP NPI 1437335551

NPI Information

  • NPI: 1437335551
  • Provider Name: JENNIFER M. CLARK, R.N., FNP, PMHNP
  • Classification: Nurse Practitioner - 363L00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 500 DOYLE PARK DR STE G04
    SANTA ROSA, CA
    ZIP 95405
  • Phone: (707) 303-8349

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NPI Details

Jennifer M. Clark, R.N., FNP, PMHNP is a nurse practitioner in Santa Rosa, CA. The provider is (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. Jennifer M. Clark, R.N., FNP, PMHNP NPI is 1437335551. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

500 DOYLE PARK DR STE G04
SANTA ROSA, CA
ZIP 95405-559
Phone: (707) 303-8349
Fax: (707) 303-2694

The NPI 1437335551 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Follow-up nursing facility visit per day, typically 15 minutes (HCPCS:99308)
  • Removal of skin and tissue, 20.0 sq cm or less (HCPCS:11042)

The enumeration date for this NPI number is 1/18/2008 and was last updated on 5/8/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363L00000XNurse Practitioner740722TEXASNo
2363L00000XNurse PractitionerNP12069CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1193487901MEDICAIDTEXAS
28Y5099OTHERTEXASBCBS
3P00622287OTHERTEXASRR MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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