JENNIFER BLUM PSYD LICENSED PSYCHOLOGIST PC
NPI 1639543390
Psychologist - Clinical in Santa Rosa, CA

Q: What is Jennifer Blum Psyd Licensed Psychologist PC's specialty?

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

Active since November 18, 2015

1144 SONOMA AVE STE 104, SANTA ROSA, CA 95405(707) 331-4769 Get Directions Write a Review

NPPES record last updated: November 18, 2015. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Jennifer Blum Psyd Licensed Psychologist Pc NPPES

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

JENNIFER BLUM PSYD LICENSED PSYCHOLOGIST PC (NPI 1639543390) is a healthcare organization registered as a clinical in Santa Rosa, California and active in the NPI registry since November 2015. The organization lists Jennifer Blum, Owner, as its authorized official.

NPPES Registry Identity

NPI1639543390

Entity TypeOrganization

Primary Taxonomy103TC0700X

Legal Business NameJENNIFER BLUM PSYD LICENSED PSYCHOLOGIST PC

Location Address1144 SONOMA AVE STE 104Santa Rosa, CA 95405-4812

Mailing Address484 Cornish LnAngwin, CA 94508-9736 · (707) 331-4769

Phone(707) 331-4769

Organization SubpartNo

Authorized OfficialJennifer BlumOwner · (707) 331-4769

Enumeration DateNovember 18, 2015

✔ NPI 1639543390 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 · 27164

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.

1144 SONOMA AVE STE 104, Santa Rosa, CA 95405

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jennifer Blum Psyd Licensed Psychologist Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Jennifer Blum Psyd Licensed Psychologist PC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Jennifer Blum, PSYD

Clinical Psychologist

NPI 1366820474

2970 CAMINO DIABLO STE 300
Walnut Creek, CA 94597

(925) 282-1778

✔ PECOS✔ Accepts Medicare50 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Blum Psyd Licensed Psychologist PC's NPI number?

The NPI number for Jennifer Blum Psyd Licensed Psychologist PC is 1639543390. It was assigned to this organization in the NPPES registry on November 18, 2015.

Where is Jennifer Blum Psyd Licensed Psychologist PC located?

Jennifer Blum Psyd Licensed Psychologist PC is located at 1144 Sonoma Ave Ste 104, Santa Rosa, CA 95405. The listed phone number is (707) 331-4769.

What is Jennifer Blum Psyd Licensed Psychologist PC's specialty?

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

Is Jennifer Blum Psyd Licensed Psychologist PC enrolled in Medicare?

Yes. Jennifer Blum Psyd Licensed Psychologist PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Jennifer Blum Psyd Licensed Psychologist PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Jennifer Blum Psyd Licensed Psychologist PC. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Jennifer Blum Psyd Licensed Psychologist PC was last updated on November 18, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.