JENNIFER ANNE GORDILLO
NPI 1023484292
Marriage & Family Therapist in San Bernardino, CA
About Jennifer Anne Gordillo NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JENNIFER ANNE GORDILLO (NPI 1023484292) is an individual marriage & family therapist in San Bernardino, California, licensed in California (IMF75155) and active in the NPI registry since August 2015. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jennifer Anne Gordillo is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Jennifer Gordillo reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Fontana, CA 92335
- Reassigned Medicare billing, California enrollment
- 5,228 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 12
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SAN BERNARDINO, CA 92408
SAN BERNARDINO, CA 92408
SAN BERNARDINO, CA 92408
SAN BERNARDINO, CA 92408
SAN BERNARDINO, CA 92408
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 Jennifer Gordillo's NPI number?
The NPI number for Jennifer Gordillo is 1023484292. It was assigned to this individual provider in the NPPES registry on August 11, 2015.
Where is Jennifer Gordillo located?
Jennifer Gordillo practices at 325 W Hospitality Ln Ste 312, San Bernardino, CA 92408. The listed phone number is (866) 205-3595.
What is Jennifer Gordillo's specialty?
The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.
Is Jennifer Gordillo enrolled in Medicare?
Yes. Jennifer Gordillo is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Jennifer Gordillo's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jennifer Gordillo reassigns Medicare benefits to Southern California Permanente Medical Group (Fontana, CA). The 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 Jennifer Gordillo'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 Jennifer Gordillo was last updated on December 28, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Jennifer Anne Gordillo · NPI 1023484292
Marriage & Family Therapist provider in San Bernardino, California. Individual provider, active in the CMS NPPES registry since August 11, 2015.
## Identity
- **NPI:** 1023484292 (Entity type: Individual)
- **Enumerated:** August 11, 2015
- **Primary specialty:** Marriage & Family Therapist · taxonomy 106H00000X
- **State license:** IMF75155 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 325 W HOSPITALITY LN STE 312, San Bernardino, CA 92408-3212
- **Phone:** (866) 205-3595
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Southern California Permanente Medical Group (NPI 1689606196, Fontana, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 28, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1023484292) · Data from the CMS NPPES public registry.