DR. JILL LANDERHOLM PH.D.
NPI 1962623629
Psychologist - Clinical in Sacramento, CA

Q: What is Jill Landerholm's NPI number?

The NPI number for Jill Landerholm is 1962623629. It was assigned to this individual provider in the NPPES registry on May 1, 2007.

Q: What is Jill Landerholm's specialty?

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

Q: Is Jill Landerholm enrolled in Medicare?

No. Jill Landerholm has opted out of Medicare through April 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Jill Landerholm was last updated on January 26, 2022. 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.

Active since May 01, 2007Opted out of Medicare · through Apr 1, 2027

949 UNIVERSITY AVE STE 200, SACRAMENTO, CA 95825(916) 599-3004 Get Directions Write a Review

NPPES record last updated: January 26, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Jill Landerholm Ph.d. NPPES

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

DR. JILL LANDERHOLM PH.D. (NPI 1962623629) is an individual clinical provider in Sacramento, California, licensed in California (PSY16984) and active in the NPI registry since May 2007. She has opted out of Medicare through April 1, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1962623629

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameDR. JILL LANDERHOLMCredential: PH.D.

Location Address949 UNIVERSITY AVE STE 200Sacramento, CA 95825-6728

Mailing Address949 University Ave Ste 200Sacramento, CA 95825-6728 · (916) 599-3004

Phone(916) 599-3004

Sole ProprietorYes

Enumeration DateMay 1, 2007

Last NPPES UpdateJanuary 26, 2022

NPPES CertifiedJanuary 26, 2022

✔ NPI 1962623629 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 · PSY16984

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.

949 UNIVERSITY AVE STE 200, Sacramento, CA 95825

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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. Jill Landerholm Ph.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 April 1, 2015 through April 1, 2027.

Opt-Out Effective DateApril 1, 2015

Opt-Out In Effect ThroughApril 1, 2027Opt-out affidavits renew automatically every two years unless cancelled

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