Active NPI
Jennifer Danielle Bielenberg, PSY.D.
- Psychologist
- Portland, OR
National Provider Identifier
1356997720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY31402
- Practice address
- 1631 NE Broadway St # 2045
Portland, OR 97232-1425 - Phone
- (253) 693-0113
- NPI assigned
- Aug 12, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY31402 | CA | Primary |
Addresses
Primary practice location
1631 NE Broadway St # 2045
Portland, OR 97232-1425
Mailing address
1631 NE Broadway St # 2045
Portland, OR 97232-1425
Phone (253) 693-0113
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 1, 2021 through Jul 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY31402 | CA | MD | Psychologist |
| 31402 | CA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stanford Health Care | 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.
-
dba Stanford Medical Center A Trade Name for Stanford Health Care
- General Acute Care Hospital
- Stanford, CA
- NPI 1437292927
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565568000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787097600000",
"number": "1356997720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1631 NE BROADWAY ST # 2045",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972321425",
"telephone_number": "253-693-0113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1631 NE BROADWAY ST # 2045",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972321425",
"telephone_number": "253-693-0113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BIELENBERG",
"first_name": "JENNIFER",
"middle_name": "DANIELLE",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-12",
"last_updated": "2026-08-19",
"certification_date": "2026-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY31402",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.