MISS JENNIFER WIDERHORN
NPI 1699296897
Marriage & Family Therapist in Santa Rosa, CA
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
Specialties & Licenses 3
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
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.
Medicare Billing Reassignment
Medicare enrollment records show Jennifer Widerhorn reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
San Francisco, CA 94131
- Reassigned Medicare billing, California enrollment
- Medicare enrollment name: Brightside Medical PC
- 63 clinicians in this Medicare group
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 15
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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.
Which organization bills Medicare for Jennifer Widerhorn's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jennifer Widerhorn reassigns Medicare benefits to Brightside Medical, P.C. (San Francisco, 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 Jennifer Widerhorn'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 Jennifer Widerhorn was last updated on December 1, 2021. 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.
# Miss Jennifer Widerhorn · NPI 1699296897
Marriage & Family Therapist provider in Santa Rosa, California. Individual provider, active in the CMS NPPES registry since June 28, 2017.
## Identity
- **NPI:** 1699296897 (Entity type: Individual)
- **Enumerated:** June 28, 2017
- **Primary specialty:** Marriage & Family Therapist · taxonomy 106H00000X
- **State license:** 123389 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 1260 N DUTTON AVE STE 105, Santa Rosa, CA 95401-7121
- **Phone:** (707) 568-2300
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Brightside Medical, P.C. (NPI 1801355482, San Francisco, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2017
## Record status
- **NPPES last updated:** December 1, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1699296897) · Data from the CMS NPPES public registry.