HEATHER PEDERSEN PH.D.
NPI 1083032635
Clinical Neuropsychologist in Clovis, CA
About Heather Pedersen Ph.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
HEATHER PEDERSEN PH.D. (NPI 1083032635) is an individual clinical neuropsychologist in Clovis, California, licensed in California (PSY31209) and active in the NPI registry since April 2014. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2012).
NPPES Registry Identity
Specialties & Licenses 6
Secondary Practice Locations 2
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
Heather Pedersen Ph.d. 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.
Medicare Billing Reassignments
2Medicare enrollment records show Heather Pedersen reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Clovis, CA 93612
- Reassigned Medicare billing, California enrollment
Fresno, CA 93611
- Reassigned Medicare billing, California enrollment
- 508 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.
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.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
CLOVIS, CA 93612
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 Heather Pedersen's NPI number?
The NPI number for Heather Pedersen is 1083032635. It was assigned to this individual provider in the NPPES registry on April 1, 2014.
Where is Heather Pedersen located?
Heather Pedersen practices at 264 Clovis Ave # 104, Clovis, CA 93612. The listed phone number is (559) 777-9061.
What is Heather Pedersen's specialty?
The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.
Is Heather Pedersen enrolled in Medicare?
Yes. Heather Pedersen 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 Heather Pedersen's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Heather Pedersen reassigns Medicare benefits to 2 organizations: Pacific Stone Psychology Corporation (Clovis, CA) and Community Foundation Medical Group (Fresno, 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 Heather Pedersen'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 Heather Pedersen was last updated on April 21, 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.
# Heather Pedersen, PH.D. · NPI 1083032635
Clinical Neuropsychologist provider in Clovis, California. Individual provider, active in the CMS NPPES registry since April 1, 2014.
## Identity
- **NPI:** 1083032635 (Entity type: Individual)
- **Enumerated:** April 1, 2014
- **Primary specialty:** Clinical Neuropsychologist · taxonomy 103G00000X
- **State license:** PSY31209 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 264 CLOVIS AVE # 104, Clovis, CA 93612-1115
- **Phone:** (559) 777-9061
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Pacific Stone Psychology Corporation (NPI 1770167371, Clovis, CA); Community Foundation Medical Group (NPI 1376056721, Fresno, CA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2012
## Record status
- **NPPES last updated:** April 21, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1083032635) · Data from the CMS NPPES public registry.