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PHYLLIS FARMER
NPI 1639899818
Social Worker - Clinical in Stockton, CA

Active since August 30, 2022PECOS Enrolled
3645 SHADOWBROOK DR, STOCKTON, CA 95219(209) 518-9789 Get Directions Write a Review

NPPES record last updated: August 30, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Phyllis Farmer NPPES

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

PHYLLIS FARMER (NPI 1639899818) is an individual clinical provider in Stockton, California, licensed in Arizona (20579) and active in the NPI registry since August 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1639899818
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NamePHYLLIS FARMER
Location Address3645 SHADOWBROOK DRStockton, CA 95219-1726
Mailing Address3645 Shadowbrook DrStockton, CA 95219-1726 · (209) 518-9789
Phone(209) 518-9789
Sole ProprietorYes
Enumeration DateAugust 30, 2022
NPPES CertifiedAugust 30, 2022
✔ NPI 1639899818 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Licenses✔ Licensed in AZ · 20579✔ Licensed in CA · 79760
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
3645 SHADOWBROOK DR, Stockton, CA 95219
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Phyllis Farmer 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.

Medicare Billing Reassignment

Medicare enrollment records show Phyllis Farmer reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Sud Specialty Group - Ca
53 mi
Addiction Medicine
4633 OLD IRONSIDES DR STE 304
Santa Clara, CA 95054
  • Reassigned Medicare billing, California enrollment
  • 1,607 clinicians in this Medicare group
NPI 1972138238 (323) 205-7088

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95219 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
$0.00 typical visit price
range $58.87 – $176.60
Typical copayment $0.00 (range $14.71 – $44.15)
Most-billed visit code NA
Established Patient
$73.16 typical visit price
range $19.28 – $144.60
Typical copayment $18.29 (range $4.82 – $36.15)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Phyllis Farmer's NPI number?

The NPI number for Phyllis Farmer is 1639899818. It was assigned to this individual provider in the NPPES registry on August 30, 2022.

Where is Phyllis Farmer located?

Phyllis Farmer practices at 3645 Shadowbrook Dr, Stockton, CA 95219. The listed phone number is (209) 518-9789.

What is Phyllis Farmer's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Phyllis Farmer enrolled in Medicare?

Yes. Phyllis Farmer is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Phyllis Farmer's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Phyllis Farmer reassigns Medicare benefits to Sud Specialty Group - Ca (Santa Clara, 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 Phyllis Farmer'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 Phyllis Farmer was last updated on August 30, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.