Jennifer Theresa Bereta, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP61687119 Issued in WA

Practice address

10333 19TH Ave SE Ste 109
Everett, WA 98208-4267

Phone

(425) 742-4600

NPI assigned

May 26, 2025

Last updated

May 28, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Shifa Health PLLCGroup PAC ID 9638070501, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Shifa Health PLLC

  • Cognitive & Behavioral Psychologist
  • Mount Vernon, WA
  • NPI 1356415327
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1748217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1417740267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22226 151ST PL SE",
            "city": "MONROE",
            "state": "WA",
            "postal_code": "982728413",
            "telephone_number": "208-818-6849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10333 19TH AVE SE STE 109",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982084267",
            "telephone_number": "425-742-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERETA",
        "first_name": "JENNIFER",
        "middle_name": "THERESA",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-26",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61687119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amie Bensouda
• James Lester Benthuysen
• Connor Bentivoglio, MA COUNSELING
• Mickayla Bentley
• Autumn Kimberly Bercier, L.M.P
• Jasmine Berg-Oliver
• Breauna Berg
• Jodi L Berg, ND, LAC, LMP, MS RDE
• Rachel Ellen Berger, LICSW, MHP
• Laura Bergeron-Hart, FNP

• Psychiatric/Mental Health Nurse Practitioner in Everett, WA
• Providers in Everett, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.