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JACQUELYN IRENE MITCHELL MFTI
NPI 1750620902
Marriage & Family Therapist in Modesto, CA

Active since February 07, 2013PECOS EnrolledAccepts Medicare Assignment
3049 DARLENE LN, MODESTO, CA 95355(209) 535-1997 Get Directions Write a Review

NPPES record last updated: February 7, 2013. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Jacquelyn Irene Mitchell Mfti NPPES

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

JACQUELYN IRENE MITCHELL MFTI (NPI 1750620902) is an individual marriage & family therapist in Modesto, California, licensed in California (IMF 56335) and active in the NPI registry since February 2013. She is enrolled in Medicare PECOS and is a graduate of Other (2007).

NPPES Registry Identity

NPI1750620902
Entity TypeIndividualFemale
Primary Taxonomy106H00000X
Provider Legal NameJACQUELYN IRENE MITCHELLCredential: MFTI
Location Address3049 DARLENE LNModesto, CA 95355-4157
Mailing Address3049 Darlene LnModesto, CA 95355-4157 · (209) 535-1997
Phone(209) 535-1997
Sole ProprietorYes
Medical School CMSOtherGraduated 2007
Enumeration DateFebruary 7, 2013
✔ NPI 1750620902 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers
Taxonomy Code106H00000X
License✔ Licensed in CA · IMF 56335
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.
3049 DARLENE LN, Modesto, CA 95355
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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 and accepts Medicare assignment

Jacquelyn Irene Mitchell Mfti 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 ID2264870351
PECOS Enrollment IDI20240409002682
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 Reassignments

3

Medicare enrollment records show Jacquelyn Mitchell reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

County Of Amador
49 mi
Community/Behavioral Health
10877 CONDUCTOR BOULEVARD, SUITE 300
Sutter Creek, CA 95685
  • Reassigned Medicare billing, California enrollment
  • 14 clinicians in this Medicare group
NPI 1205055886 (209) 223-6412
Sud Specialty Group - Ca
60 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
Cyti Health PC
402 mi
Mental Health (Including Community Mental Health Center)
402 W BROADWAY STE 400
San Diego, CA 92101
  • Reassigned Medicare billing, California enrollment
  • 545 clinicians in this Medicare group
NPI 1679172290 (866) 478-3978

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 Jacquelyn Mitchell's NPI number?

The NPI number for Jacquelyn Mitchell is 1750620902. It was assigned to this individual provider in the NPPES registry on February 7, 2013.

Where is Jacquelyn Mitchell located?

Jacquelyn Mitchell practices at 3049 Darlene Ln, Modesto, CA 95355. The listed phone number is (209) 535-1997.

What is Jacquelyn Mitchell's specialty?

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

Is Jacquelyn Mitchell enrolled in Medicare?

Yes. Jacquelyn Mitchell 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 organizations bill Medicare for Jacquelyn Mitchell's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jacquelyn Mitchell reassigns Medicare benefits to 3 organizations: County Of Amador (Sutter Creek, CA), Sud Specialty Group - Ca (Santa Clara, CA) and Cyti Health PC (San Diego, CA). Each 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 Jacquelyn Mitchell'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 Jacquelyn Mitchell was last updated on February 7, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.