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JACQUELYN KESSERMAN LCSW
NPI 1003491671
Social Worker - Clinical in Buena Park, CA

Active since March 15, 2021PECOS EnrolledAccepts Medicare Assignment
10350 MIRANDA AVE, BUENA PARK, CA 90620(562) 715-8703 Get Directions Write a Review

NPPES record last updated: March 15, 2021. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Jacquelyn Kesserman Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACQUELYN KESSERMAN LCSW (NPI 1003491671) is an individual clinical provider in Buena Park, California, licensed in California (LCSW81103) and active in the NPI registry since March 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2014).

NPPES Registry Identity

NPI1003491671
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameJACQUELYN KESSERMANCredential: LCSW
Location Address10350 MIRANDA AVEBuena Park, CA 90620-4447
Mailing Address10350 Miranda AveBuena Park, CA 90620-4447 · (562) 715-8703
Phone(562) 715-8703
Sole ProprietorYes
Medical School CMSOtherGraduated 2014
Enumeration DateMarch 15, 2021
NPPES CertifiedMarch 15, 2021
✔ NPI 1003491671 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in CA · LCSW81103
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
10350 MIRANDA AVE, Buena Park, CA 90620
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jacquelyn Kesserman Lcsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3971968983
PECOS Enrollment IDI20230426002700
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Jacquelyn Kesserman reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Soultenders, Inc.
23 mi
Clinical
41 E FOOTHILL BLVD, SUITE 102
Arcadia, CA 91006
  • Reassigned Medicare billing, California enrollment
  • 273 clinicians in this Medicare group
NPI 1164617007 (626) 737-6034
Soultenders Psychological Services, Inc.
23 mi
Clinical
41 E FOOTHILL BLVD STE 102
Arcadia, CA 91006
  • Reassigned Medicare billing, California enrollment
  • 255 clinicians in this Medicare group
NPI 1235810722 (626) 701-4249

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90620 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $62.96 – $187.60
Typical copayment $0.00 (range $15.74 – $46.90)
Most-billed visit code NA
Established Patient
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacquelyn Kesserman's NPI number?

The NPI number for Jacquelyn Kesserman is 1003491671. It was assigned to this individual provider in the NPPES registry on March 15, 2021.

Where is Jacquelyn Kesserman located?

Jacquelyn Kesserman practices at 10350 Miranda Ave, Buena Park, CA 90620. The listed phone number is (562) 715-8703.

What is Jacquelyn Kesserman's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Jacquelyn Kesserman enrolled in Medicare?

Yes. Jacquelyn Kesserman is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Jacquelyn Kesserman's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jacquelyn Kesserman reassigns Medicare benefits to 2 organizations: Soultenders, Inc. (Arcadia, CA) and Soultenders Psychological Services, Inc. (Arcadia, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jacquelyn Kesserman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jacquelyn Kesserman was last updated on March 15, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.