JACQUELINE OLIVIA CHILDS
NPI 1376992867
Marriage & Family Therapist in Campbell, CA

Q: What is Jacqueline Childs's NPI number?

The NPI number for Jacqueline Childs is 1376992867. It was assigned to this individual provider in the NPPES registry on June 6, 2016. The provider is also known as Jackie Olivia Childs.

Q: What is Jacqueline Childs's specialty?

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

Q: Is Jacqueline Childs enrolled in Medicare?

No. Jacqueline Childs 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.

Q: When was this NPI record last updated?

The NPPES record for Jacqueline Childs was last updated on October 29, 2020. 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.

Active since June 06, 2016Opted out of Medicare · through Jan 1, 2028

251 LLEWELLYN AVE, CAMPBELL, CA 95008(408) 379-3790 Get Directions Write a Review

NPPES record last updated: October 29, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 29, 2020, Mar 7, 2019 (2 updates tracked since 2019).

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About Jacqueline Olivia Childs NPPES

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

JACQUELINE OLIVIA CHILDS (NPI 1376992867) is an individual marriage & family therapist in Campbell, California, licensed in California (122336) and active in the NPI registry since June 2016. She has opted out of Medicare through January 1, 2028.

NPPES Registry Identity

NPI1376992867

Entity TypeIndividualFemale

Primary Taxonomy106H00000X

Provider Legal NameJACQUELINE OLIVIA CHILDS

Location Address251 LLEWELLYN AVECampbell, CA 95008-1940

Mailing Address251 Llewellyn AveCampbell, CA 95008-1940 · (408) 379-3790

Phone(408) 379-3790

Sole ProprietorYes

Enumeration DateJune 6, 2016

Last NPPES UpdateOctober 29, 20202 updates tracked since enumeration

NPPES CertifiedOctober 29, 2020

✔ NPI 1376992867 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers

Taxonomy Code106H00000X

License✔ Licensed in CA · 122336

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.

Also ListedBehavior AnalystTaxonomy 103K00000X · License F2928188 (CA)

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

251 LLEWELLYN AVE, Campbell, CA 95008

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Other Names 1

Other Name (5)Jackie Olivia Childs

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Jacqueline Olivia Childs 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 20

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

MICHAEL CASTOR

Case Manager/Care Coordinator