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JESSICA WILLIAMSON
NPI 1689062754
Student in an Organized Health Care Education/Training Program in Culver City, CA

Active since December 24, 2014PECOS Enrolled
9808 VENICE BLVD, STE. 505, CULVER CITY, CA 90232(310) 945-3350(310) 945-3356 Get Directions Write a Review

NPPES record last updated: December 24, 2014. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Jessica Williamson NPPES

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

JESSICA WILLIAMSON (NPI 1689062754) is an individual student in an organized health care education/training program in Culver City, California and active in the NPI registry since December 2014. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1689062754
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameJESSICA WILLIAMSON
Location Address9808 VENICE BLVD, STE. 505Culver City, CA 90232-2732
Mailing Address9808 Venice Blvd, Ste. 505Culver City, CA 90232-2732 · (310) 945-3350 · Fax (310) 945-3356
Phone(310) 945-3350
Fax(310) 945-3356
Sole ProprietorYes
Medical School CMSOtherGraduated 2020
Enumeration DateDecember 24, 2014
✔ NPI 1689062754 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
9808 VENICE BLVD, Culver City, CA 90232
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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)

Jessica Williamson is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID941778948
PECOS Enrollment IDI20260507003511
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 Jessica Williamson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Department Of State Hospitals
20 mi
Psychiatric Hospital
11401 BLOOMFIELD AVE
Norwalk, CA 90650
  • Reassigned Medicare billing, California enrollment
  • 755 clinicians in this Medicare group
NPI 1265406565 (562) 863-7011

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 20

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

JOSEPH A DERIJE NP
Nurse Practitioner (Psychiatric/Mental Health)
9808 VENICE BLVD, SUITE 700
CULVER CITY, CA 90232
Los Angeles County (310) 945-3350
HENRY P DURAZO
Rehabilitation Practitioner
9808 VENICE BLVD, SUITE 700
CULVER CITY, CA 90232
Los Angeles County (310) 945-3350
SOLEDAD VERGARA
Rehabilitation Practitioner
9808 VENICE BLVD, SUITE 700
CULVER CITY, CA 90232
Los Angeles County (310) 945-3350
CHERRYL DIOM
Registered Nurse (Psychiatric/Mental Health)
9808 VENICE BLVD, STE. 505
CULVER CITY, CA 90232
Los Angeles County (310) 945-3350
LAUREN MCFARLAND
Rehabilitation Practitioner
9808 VENICE BLVD, STE. 505
CULVER CITY, CA 90232
Los Angeles County (310) 945-3350
SHERRI BETHELMY
Rehabilitation Practitioner
9808 VENICE BLVD
CULVER CITY, CA 90232
Los Angeles County (310) 945-3350
JANINE RENEE STEWART
Rehabilitation Practitioner
9808 VENICE BLVD
CULVER CITY, CA 90232
Los Angeles County (310) 945-3350
TERRIE ADDISON
Community Health Worker
9808 VENICE BLVD, 505
CULVER CITY, CA 90232
Los Angeles County (310) 945-3350

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 Jessica Williamson's NPI number?

The NPI number for Jessica Williamson is 1689062754. It was assigned to this individual provider in the NPPES registry on December 24, 2014.

Where is Jessica Williamson located?

Jessica Williamson practices at 9808 Venice Blvd Ste. 505, Culver City, CA 90232. The listed phone number is (310) 945-3350.

What is Jessica Williamson's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Jessica Williamson enrolled in Medicare?

Yes. Jessica Williamson is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jessica Williamson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jessica Williamson reassigns Medicare benefits to Department Of State Hospitals (Norwalk, 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 Jessica Williamson'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 Jessica Williamson was last updated on December 24, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.