JENNA KARLSBERG BENNETT
NPI 1417575499
Psychologist in Burbank, CA

Active since July 07, 2020Opted out of Medicare · through Jan 3, 2028
221 N 3RD ST # 443, BURBANK, CA 91502(424) 253-4656 Get Directions Write a Review

NPPES record last updated: June 9, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 9, 2023, Jul 7, 2020 (2 updates tracked since 2020).

About Jenna Karlsberg Bennett NPPES

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

JENNA KARLSBERG BENNETT (NPI 1417575499) is an individual psychologist in Burbank, California, licensed in California (PSY34258) and active in the NPI registry since July 2020. She has opted out of Medicare through January 3, 2028.

NPPES Registry Identity

NPI1417575499
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameJENNA KARLSBERG BENNETT
Location Address221 N 3RD ST # 443Burbank, CA 91502-1202
Mailing Address221 N 3rd St # 443Burbank, CA 91502-1202 · (424) 253-4656
Sole ProprietorYes
Enumeration DateJuly 7, 2020
Last NPPES UpdateJune 9, 20232 updates tracked since enumeration
NPPES CertifiedApril 13, 2023
NPI 1417575499 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 · PSY34258
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.
221 N 3RD ST # 443, Burbank, CA 91502

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Opted out of Medicare

Jenna Karlsberg Bennett 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 3, 2024 through January 3, 2028.

Opt-Out Effective DateJanuary 3, 2024
Opt-Out In Effect ThroughJanuary 3, 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.

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 Jenna Bennett's NPI number?

The NPI number for Jenna Bennett is 1417575499. It was assigned to this individual provider in the NPPES registry on July 7, 2020.

Where is Jenna Bennett located?

Jenna Bennett practices at 221 N 3rd St # 443, Burbank, CA 91502. The listed phone number is (424) 253-4656.

What is Jenna Bennett's specialty?

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

Is Jenna Bennett enrolled in Medicare?

No. Jenna Bennett has opted out of Medicare through January 3, 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 Jenna Bennett was last updated on June 9, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.