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JENNIFER POLSE PAYNE MA
NPI 1336493261
Marriage & Family Therapist in Berkeley, CA

Active since October 30, 2012Opted out of Medicare · through Jan 1, 2028
2127 ASHBY AVE, SUITE 3, BERKELEY, CA 94705(510) 813-0552 Get Directions Write a Review

NPPES record last updated: October 30, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jennifer Polse Payne Ma NPPES

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

JENNIFER POLSE PAYNE MA (NPI 1336493261) is an individual marriage & family therapist in Berkeley, California, licensed in California (MFC 48017) and active in the NPI registry since October 2012. She has opted out of Medicare through January 1, 2028.

NPPES Registry Identity

NPI1336493261
Entity TypeIndividualFemale
Primary Taxonomy106H00000X
Provider Legal NameJENNIFER POLSE PAYNECredential: MA
Location Address2127 ASHBY AVE, SUITE 3Berkeley, CA 94705-1884
Mailing Address2127 Ashby Ave, Suite 3Berkeley, CA 94705-1884
Phone(510) 813-0552
Sole ProprietorYes
Enumeration DateOctober 30, 2012
✔ NPI 1336493261 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers
Taxonomy Code106H00000X
License✔ Licensed in CA · MFC 48017
Definition
A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.
2127 ASHBY AVE, Berkeley, CA 94705
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Jennifer Polse Payne Ma has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2024 through January 1, 2028.

Opt-Out Effective DateJanuary 1, 2024
Opt-Out In Effect ThroughJanuary 1, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 16

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

GABE RAFF MFT
Marriage & Family Therapist
2127 ASHBY AVE
BERKELEY, CA 94705
Alameda County (510) 646-1046
MS. CARA JANE ZEISLOFT LCSW
Social Worker (Clinical)
2127 ASHBY AVE
BERKELEY, CA 94705
Alameda County (510) 594-4331
MS. CLAIRE STONE MFT
Marriage & Family Therapist
2127 ASHBY AVE
BERKELEY, CA 94705
Alameda County (510) 868-1874
DR. LESLIE CATHERINE BELL
Social Worker (Clinical)
2127 ASHBY AVE
BERKELEY, CA 94705
Alameda County (510) 548-7960
KRISTIN LAMOUREUX MA, MFT
Marriage & Family Therapist
2127 ASHBY AVE
BERKELEY, CA 94705
Alameda County (415) 425-6334
MS. SUSANNA GILBERT MFT
Marriage & Family Therapist
2127 ASHBY AVE
BERKELEY, CA 94705
Alameda County (510) 646-0396
ASHBY PSYCHOTHERAPY ASSOCIATES
Marriage & Family Therapist
2127 ASHBY AVE
BERKELEY, CA 94705
Alameda County (510) 548-7960
MARY DIASO RUDY L.C.S.W.
Social Worker (Clinical)
2127 ASHBY AVE
BERKELEY, CA 94705
Alameda County (510) 540-6678

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 Payne's NPI number?

The NPI number for Jennifer Payne is 1336493261. It was assigned to this individual provider in the NPPES registry on October 30, 2012.

Where is Jennifer Payne located?

Jennifer Payne practices at 2127 Ashby Ave Suite 3, Berkeley, CA 94705. The listed phone number is (510) 813-0552.

What is Jennifer Payne's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Is Jennifer Payne enrolled in Medicare?

No. Jennifer Payne has opted out of Medicare through January 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Jennifer Payne was last updated on October 30, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.