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DR. JENNIFER WYDRO PSY.D.
NPI 1346345485
Psychologist - Clinical in Berkeley, CA

Active since September 13, 2006PECOS EnrolledAccepts Medicare Assignment
2640 MARTIN LUTHER KING JR WAY, BERKELEY, CA 94704(510) 981-5254(510) 981-6525 Get Directions Write a Review

NPPES record last updated: October 25, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Dr. Jennifer Wydro Psy.d. NPPES

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

DR. JENNIFER WYDRO PSY.D. (NPI 1346345485) is an individual clinical provider in Berkeley, California, licensed in California (PSY22254) and active in the NPI registry since September 2006. She is enrolled in Medicare PECOS and is a graduate of Other (2007).

NPPES Registry Identity

NPI1346345485
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameDR. JENNIFER WYDROCredential: PSY.D.
Location Address2640 MARTIN LUTHER KING JR WAYBerkeley, CA 94704-3238
Mailing Address2640 Martin Luther King Jr WayBerkeley, CA 94704-3238 · (510) 981-5254 · Fax (510) 981-6525
Phone(510) 981-5254
Fax(510) 981-6525
Sole ProprietorNo
Medical School CMSOtherGraduated 2007
Enumeration DateSeptember 13, 2006
Last NPPES UpdateOctober 25, 2022
NPPES CertifiedOctober 25, 2022
✔ NPI 1346345485 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in CA · PSY22254
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
2640 MARTIN LUTHER KING JR WAY, Berkeley, CA 94704
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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

Dr. Jennifer Wydro Psy.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.

PECOS PAC ID6204022437
PECOS Enrollment IDI20101130000317
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 Jennifer Wydro reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Permanente Medical Group Inc
7.2 mi
Internal Medicine
901 NEVIN
Richmond, CA 94801
  • Reassigned Medicare billing, California enrollment
  • 20,078 clinicians in this Medicare group
NPI 1235226531 (510) 307-1555

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 94704 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
$202.35 typical visit price
range $69.00 – $202.35
Typical copayment $50.58 (range $17.25 – $50.58)
Most-billed visit code 99205
Established Patient
$119.48 typical visit price
range $23.44 – $166.46
Typical copayment $29.87 (range $5.86 – $41.61)
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 20

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

MARGARET SUSAN HIGGINS RN
Registered Nurse (Psychiatric/Mental Health)
2640 MARTIN LUTHER KING JR WAY
BERKELEY, CA 94704
Alameda County (510) 981-5290
JULIE ANN OQUERIZA MARIANO
Registered Nurse (Psychiatric/Mental Health, Adult)
2640 MARTIN LUTHER KING JR WAY
BERKELEY, CA 94704
Alameda County (510) 981-5290
JAMES RUBIN GLENN
Social Worker
2640 MARTIN LUTHER KING JR WAY
BERKELEY, CA 94704
Alameda County (510) 981-5290
LELAND S JOHNSON MFT
Marriage & Family Therapist
2640 MARTIN LUTHER KING JR WAY
BERKELEY, CA 94704
Alameda County (510) 981-5290
BRYAN THUNSTEDT RN
Registered Nurse
2640 MARTIN LUTHER KING JR WAY
BERKELEY, CA 94704
Alameda County (510) 981-5290
MR. MICHAEL HILTON MARCHANT LCSW
Social Worker (Clinical)
2640 MARTIN LUTHER KING JR WAY
BERKELEY, CA 94704
Alameda County (510) 981-5290
MISS AMANDA HARTMAN
Student in an Organized Health Care Education/Training Program
2640 MARTIN LUTHER KING JR WAY
BERKELEY, CA 94704
Alameda County (510) 981-5290
KATHARINE VIDT
Student in an Organized Health Care Education/Training Program
2640 MARTIN LUTHER KING JR WAY
BERKELEY, CA 94704
Alameda County (510) 981-5290

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 Wydro's NPI number?

The NPI number for Jennifer Wydro is 1346345485. It was assigned to this individual provider in the NPPES registry on September 13, 2006.

Where is Jennifer Wydro located?

Jennifer Wydro practices at 2640 Martin Luther King Jr Way, Berkeley, CA 94704. The listed phone number is (510) 981-5254.

What is Jennifer Wydro's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Jennifer Wydro enrolled in Medicare?

Yes. Jennifer Wydro 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 Jennifer Wydro's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jennifer Wydro reassigns Medicare benefits to Permanente Medical Group Inc (Richmond, 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 Wydro'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 Wydro was last updated on October 25, 2022. 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.