JENNIFER M. CLARK R.N., FNP, PMHNP
NPI 1437335551
Nurse Practitioner in Santa Rosa, CA

Q: What is Jennifer Clark's NPI number?

The NPI number for Jennifer Clark is 1437335551. It was assigned to this individual provider in the NPPES registry on January 18, 2008.

Q: What is Jennifer Clark's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Jennifer Clark was last updated on May 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.

Active since January 18, 2008PECOS Enrolled

500 DOYLE PARK DR STE G04, SANTA ROSA, CA 95405(707) 303-8349(707) 303-2694 Get Directions Write a Review

NPPES record last updated: May 8, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 8, 2025, Jul 21, 2022, Jun 9, 2017 (3 updates tracked since 2017).

On this page

About Jennifer M. Clark R.n., Fnp, Pmhnp NPPES

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

JENNIFER M. CLARK R.N., FNP, PMHNP (NPI 1437335551) is an individual nurse practitioner in Santa Rosa, California, licensed in California (NP12069) and active in the NPI registry since January 2008. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1437335551

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameJENNIFER M. CLARKCredential: R.N., FNP, PMHNP

Location Address500 DOYLE PARK DR STE G04Santa Rosa, CA 95405-4559

Mailing Address3114 Carvel DrSanta Rosa, CA 95405-7062 · (707) 757-3117 · Fax (707) 303-2694

Phone(707) 303-8349

Fax(707) 303-2694

Sole ProprietorYes

Enumeration DateJanuary 18, 2008

Last NPPES UpdateMay 8, 20253 updates tracked since enumeration

NPPES CertifiedMay 8, 2025

✔ NPI 1437335551 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

Licenses✔ Licensed in CA · NP12069✔ Licensed in TX · 740722

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

500 DOYLE PARK DR STE G04, Santa Rosa, CA 95405

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Other Identifiers 3

Medicaid193487901TX

Other8Y5099TX · Bcbs

OtherP00622287TX · Rr Medicare

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jennifer M. Clark R.n., Fnp, Pmhnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95405 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

$96.16 typical visit price

range $63.04 – $187.01

Typical copayment $24.04 (range $15.76 – $46.75)

Most-billed visit code 99203

Established Patient

$109.88 typical visit price

range $21.02 – $153.40

Typical copayment $27.47 (range $5.25 – $38.35)

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 7

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

RAJVEER SANGERA DO

Internal Medicine (Interventional Cardiology)