Active NPI
Jessica Clifton, PH.D.
- Clinical Psychologist
- Santa Rosa, CA
National Provider Identifier
1023587078
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 33447
- Practice address
- 3558 Round Barn Blvd Ste 200
Santa Rosa, CA 95403-0991 - Phone
- (707) 341-6829
- Fax
- (707) 324-3826
- NPI assigned
- Nov 20, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 048.0126352 | VT | |
| Clinical Psychologist | 103TC0700X | 33447 | CA | Primary |
Addresses
Primary practice location
3558 Round Barn Blvd Ste 200
Santa Rosa, CA 95403-0991
Mailing address
3558 Round Barn Blvd Ste 200
Santa Rosa, CA 95403-0991
Phone (707) 341-6829
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jan 31, 2023 through Jan 31, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 048.0126352 | VT | MD | Clinical Psychologist |
| 33447 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vermont Psychological Services: Leitenberg Center for Evidence-Based P | Clinical | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Clinical Psychologist
- Burlington, VT
- NPI 1598837593
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1542672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786060800000",
"number": "1023587078",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3558 ROUND BARN BLVD STE 200",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954030991",
"telephone_number": "707-341-6829",
"fax_number": "707-324-3826"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3558 ROUND BARN BLVD STE 200",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954030991",
"telephone_number": "707-341-6829",
"fax_number": "707-324-3826"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLIFTON",
"first_name": "JESSICA",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-11-20",
"last_updated": "2026-08-07",
"certification_date": "2026-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VT",
"license": "048.0126352",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "33447",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Rosa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.