DR. JENNIFER ROSE VANDERBURG PSY.D
NPI 1871695866
Psychologist - Clinical in Huntington Beach, CA

Q: What is Jennifer Vanderburg's NPI number?

The NPI number for Jennifer Vanderburg is 1871695866. It was assigned to this individual provider in the NPPES registry on September 1, 2006.

Q: What is Jennifer Vanderburg's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: Is Jennifer Vanderburg enrolled in Medicare?

No. Jennifer Vanderburg has opted out of Medicare through August 9, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Active since September 01, 2006Opted out of Medicare · through Aug 9, 2027

5762 BOLSA AVE, SUITE 107, HUNTINGTON BEACH, CA 92649(562) 804-5522 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Jennifer Rose Vanderburg Psy.d NPPES

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

DR. JENNIFER ROSE VANDERBURG PSY.D (NPI 1871695866) is an individual clinical provider in Huntington Beach, California, licensed in California (PSY 17308) and active in the NPI registry since September 2006. She has opted out of Medicare through August 9, 2027.

NPPES Registry Identity

NPI1871695866

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameDR. JENNIFER ROSE VANDERBURGCredential: PSY.D

Location Address5762 BOLSA AVE, SUITE 107Huntington Beach, CA 92649-1172

Mailing AddressPo Box 15603Long Beach, CA 90815-0603 · (562) 804-5522

Phone(562) 804-5522

Sole ProprietorYes

Enumeration DateSeptember 1, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1871695866 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in CA · PSY 17308

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

5762 BOLSA AVE, Huntington Beach, CA 92649

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Jennifer Rose Vanderburg Psy.d has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from August 9, 2023 through August 9, 2027.

Opt-Out Effective DateAugust 9, 2023

Opt-Out In Effect ThroughAugust 9, 2027Opt-out affidavits renew automatically every two years unless cancelled

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.

DIANA SANDRES MARTINEZ

Behavior Technician

5762 BOLSA AVE
HUNTINGTON BEACH, CA 92649

Orange County (714) 294-9943

ELLEN JENNY SLATON LCSW

Counselor (Professional)

5762 BOLSA AVE, SUITE 107
HUNTINGTON BEACH, CA 92649

Orange County (714) 898-0362

NICHOLE REILLY BCBA

Behavior Analyst

5762 BOLSA AVE, SUITE 101
HUNTINGTON BEACH, CA 92649

Orange County (714) 292-2322

ALEXIS LANDRUM

Behavior Technician

5762 BOLSA AVE
HUNTINGTON BEACH, CA 92649

Orange County (714) 294-9943

WENDY WEI

Behavior Technician

5762 BOLSA AVE
HUNTINGTON BEACH, CA 92649

Orange County (714) 294-9943

BAILEY STAFFORD

Behavior Technician

5762 BOLSA AVE
HUNTINGTON BEACH, CA 92649

Orange County (714) 292-2322

MARKELLA SIMMONS

Behavior Technician

5762 BOLSA AVE
HUNTINGTON BEACH, CA 92649

Orange County (714) 292-2322

HOWARD TSERNOV BCBA

Behavior Analyst

5762 BOLSA AVE, SUITE 101
HUNTINGTON BEACH, CA 92649

Orange County (714) 336-2017

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 Vanderburg's NPI number?

The NPI number for Jennifer Vanderburg is 1871695866. It was assigned to this individual provider in the NPPES registry on September 1, 2006.

Where is Jennifer Vanderburg located?

Jennifer Vanderburg practices at 5762 Bolsa Ave Suite 107, Huntington Beach, CA 92649. The listed phone number is (562) 804-5522.

What is Jennifer Vanderburg's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Jennifer Vanderburg enrolled in Medicare?

No. Jennifer Vanderburg has opted out of Medicare through August 9, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Jennifer Vanderburg was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.