MISS JENNIFER WIDERHORN
NPI 1699296897
Marriage & Family Therapist in Santa Rosa, CA

Active since June 28, 2017PECOS EnrolledAccepts Medicare Assignment
1260 N DUTTON AVE STE 105, SANTA ROSA, CA 95401(707) 568-2300 Get Directions Write a Review

NPPES record last updated: December 1, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 1, 2021, Oct 23, 2017, Jun 28, 2017 (3 updates tracked since 2017).

About Miss Jennifer Widerhorn NPPES

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

MISS JENNIFER WIDERHORN (NPI 1699296897) is an individual marriage & family therapist in Santa Rosa, California, licensed in California (123389) and active in the NPI registry since June 2017. She is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1699296897
Entity TypeIndividualFemale
Primary Taxonomy106H00000X
Provider Legal NameMISS JENNIFER WIDERHORN
Location Address1260 N DUTTON AVE STE 105Santa Rosa, CA 95401-7121
Mailing Address1260 N Dutton Ave Ste 105Santa Rosa, CA 95401-7121 · (707) 568-2300
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateJune 28, 2017
Last NPPES UpdateDecember 1, 20213 updates tracked since enumeration
NPPES CertifiedDecember 1, 2021
NPI 1699296897 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers
Taxonomy Code106H00000X
License Licensed in CA · 123389
Definition

A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

Also ListedCounselor · Mental HealthTaxonomy 101YM0800X
1260 N DUTTON AVE STE 105, Santa Rosa, CA 95401

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Miss Jennifer Widerhorn is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7810423506
PECOS Enrollment IDI20241204003156
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.

Other Providers at the Same Location NPPES 15

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

Counselor (Mental Health)
1260 N DUTTON AVE STE 105
SANTA ROSA, CA 95401
Counselor (Mental Health)
1260 N DUTTON AVE STE 105
SANTA ROSA, CA 95401
Counselor (Mental Health)
1260 N DUTTON AVE STE 105
SANTA ROSA, CA 95401
Community Health Worker
1260 N DUTTON AVE STE 105
SANTA ROSA, CA 95401
Community Health Worker
1260 N DUTTON AVE STE 105
SANTA ROSA, CA 95401
Rehabilitation Practitioner
1260 N DUTTON AVE STE 105
SANTA ROSA, CA 95401
Counselor (Mental Health)
1260 N DUTTON AVE STE 105
SANTA ROSA, CA 95401
Community Health Worker
1260 N DUTTON AVE STE 105
SANTA ROSA, CA 95401

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 Widerhorn's NPI number?

The NPI number for Jennifer Widerhorn is 1699296897. It was assigned to this individual provider in the NPPES registry on June 28, 2017.

Where is Jennifer Widerhorn located?

Jennifer Widerhorn practices at 1260 N Dutton Ave Ste 105, Santa Rosa, CA 95401. The listed phone number is (707) 568-2300.

What is Jennifer Widerhorn's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Is Jennifer Widerhorn enrolled in Medicare?

Yes. Jennifer Widerhorn is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Jennifer Widerhorn was last updated on December 1, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.