MR. JONATHAN PAUL SERNA CLINKENBEARD MS
NPI 1417574724
Psychologist in Pleasanton, CA

Active since July 02, 2020PECOS Enrolled
3825 HOPYARD RD STE 140&202, PLEASANTON, CA 94588(925) 847-5051 Get Directions Write a Review

NPPES record last updated: June 4, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Jun 4, 2026, Jul 2, 2020 (2 updates tracked since 2020).

About Mr. Jonathan Paul Serna Clinkenbeard Ms NPPES

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

MR. JONATHAN PAUL SERNA CLINKENBEARD MS (NPI 1417574724) is an individual psychologist in Pleasanton, California, licensed in California (PSY36229) and active in the NPI registry since July 2020. He is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1417574724
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameMR. JONATHAN PAUL SERNA CLINKENBEARDCredential: MS
Location Address3825 HOPYARD RD STE 140&202Pleasanton, CA 94588-8528
Mailing Address3825 Hopyard Rd Ste 140&202Pleasanton, CA 94588-8528 · (925) 847-5051
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateJuly 2, 2020
Last NPPES UpdateJune 4, 20262 updates tracked since enumeration
NPPES CertifiedJune 4, 2026
✔ NPI 1417574724 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License✔ Licensed in CA · PSY36229
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
3825 HOPYARD RD STE 140&202, Pleasanton, CA 94588

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Jonathan Paul Serna Clinkenbeard Ms is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1456836188
PECOS Enrollment IDI20260331003452
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 Jonathan Clinkenbeard reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Internal Medicine
1190 VETERANS BLVD
Redwood City, CA 94063
  • Reassigned Medicare billing, California enrollment
  • 20,078 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.

Other Providers at the Same Location NPPES 2

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

Pharmacist
3825 HOPYARD RD STE 140&202
PLEASANTON, CA 94588
Marriage & Family Therapist
3825 HOPYARD RD STE 140&202
PLEASANTON, CA 94588

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 Jonathan Clinkenbeard's NPI number?

The NPI number for Jonathan Clinkenbeard is 1417574724. It was assigned to this individual provider in the NPPES registry on July 2, 2020.

Where is Jonathan Clinkenbeard located?

Jonathan Clinkenbeard practices at 3825 Hopyard Rd Ste 140&202, Pleasanton, CA 94588. The listed phone number is (925) 847-5051.

What is Jonathan Clinkenbeard's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Jonathan Clinkenbeard enrolled in Medicare?

Yes. Jonathan Clinkenbeard is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jonathan Clinkenbeard's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jonathan Clinkenbeard reassigns Medicare benefits to Permanente Medical Group Inc (Redwood City, 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 Jonathan Clinkenbeard'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 Jonathan Clinkenbeard was last updated on June 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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.