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JACQUELYN VICTORIA ZOMMICK PMHNP
NPI 1073282786
Nurse Practitioner - Psychiatric/Mental Health in Valencia, CA

Active since September 08, 2021PECOS EnrolledAccepts Medicare Assignment
28212 KELLY JOHNSON PKWY STE 215, VALENCIA, CA 91355(818) 688-6826(877) 349-4481 Get Directions Write a Review

NPPES record last updated: March 11, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 20, 2022, Jun 11, 2022, Apr 15, 2022 and 1 more (4 updates tracked since 2021).

About Jacquelyn Victoria Zommick Pmhnp NPPES

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

JACQUELYN VICTORIA ZOMMICK PMHNP (NPI 1073282786) is an individual psychiatric/mental health provider in Valencia, California, licensed in California (95020736) and active in the NPI registry since September 2021. She is enrolled in Medicare PECOS, maintains a secondary practice location in Calabasas, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1073282786
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameJACQUELYN VICTORIA ZOMMICKCredential: PMHNP
Location Address28212 KELLY JOHNSON PKWY STE 215Valencia, CA 91355-5090
Mailing Address28212 Kelly Johnson Pkwy Ste 215Valencia, CA 91355-5090 · (818) 688-6826
Phone(818) 688-6826
Fax(877) 349-4481
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateSeptember 8, 2021
Last NPPES UpdateMarch 11, 20244 updates tracked since enumeration
NPPES CertifiedMarch 11, 2024
✔ NPI 1073282786 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in CA · 95020736
28212 KELLY JOHNSON PKWY STE 215, Valencia, CA 91355
Open in Google Maps ↗

Secondary Practice Location 1

Location 123500 Park Sorrento Unit A4Calabasas, CA 91302-4117 · Phone (818) 688-6862 · Fax (877) 349-4481

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 Victoria Zommick Pmhnp 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 ID4880060540
PECOS Enrollment IDI20221020001627
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 Reassignment

Medicare enrollment records show Jacquelyn Zommick reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mental Wellness For Life A Nursing Corporation
Same address
Psychiatric/Mental Health
28212 KELLY JOHNSON PKWY STE 215
Valencia, CA 91355
  • Reassigned Medicare billing, California enrollment
  • 6 clinicians in this Medicare group
NPI 1982326740 (818) 688-6826

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

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Psychotherapy with evaluation and management visit, 1 hour 90838
Psychotherapy with evaluation and management is a one-hour session where a mental health professional assesses your psychological state and discusses treatment options. This process aims to understand your feelings, thoughts, and behaviors to improve your overall well-being.
93 services13 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
89 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 91355 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
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRAINSTIM CENTERS, INC
Psychiatry & Neurology (Neurology)
28212 KELLY JOHNSON PKWY STE 215
VALENCIA, CA 91355
Los Angeles County (310) 314-8250
ASPIRE HOLDINGS, INC
Psychiatry & Neurology (Neurology)
28212 KELLY JOHNSON PKWY STE 215
VALENCIA, CA 91355
Los Angeles County (310) 314-8250
JENNA LAUREN ZOMMICK FNP, RN
Nurse Practitioner (Psychiatric/Mental Health)
28212 KELLY JOHNSON PKWY STE 215
VALENCIA, CA 91355
Los Angeles County (818) 688-6826
MENTAL WELLNESS FOR LIFE A NURSING CORPORATION
Nurse Practitioner (Psychiatric/Mental Health)
28212 KELLY JOHNSON PKWY STE 215
VALENCIA, CA 91355
Los Angeles County (818) 688-6826

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 Zommick's NPI number?

The NPI number for Jacquelyn Zommick is 1073282786. It was assigned to this individual provider in the NPPES registry on September 8, 2021.

Where is Jacquelyn Zommick located?

Jacquelyn Zommick practices at 28212 Kelly Johnson Pkwy Ste 215, Valencia, CA 91355. The listed phone number is (818) 688-6826.

What is Jacquelyn Zommick's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Jacquelyn Zommick enrolled in Medicare?

Yes. Jacquelyn Zommick 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 organization bills Medicare for Jacquelyn Zommick's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jacquelyn Zommick reassigns Medicare benefits to Mental Wellness For Life A Nursing Corporation (Valencia, 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 Jacquelyn Zommick'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 Zommick was last updated on March 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.