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DR. STACY KIM JOHNSTON PHD
NPI 1063569135
Psychologist - Clinical in La Mesa, CA

Active since January 04, 2007PECOS EnrolledAccepts Medicare Assignment
4730 PALM AVE, 202, LA MESA, CA 91941(619) 778-7215(619) 328-9332 Get Directions Write a Review

NPPES record last updated: August 19, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Stacy Kim Johnston Phd NPPES

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

DR. STACY KIM JOHNSTON PHD (NPI 1063569135) is an individual clinical provider in La Mesa, California, licensed in California (PSY17457) and active in the NPI registry since January 2007. She is enrolled in Medicare PECOS and is a graduate of Other (1998).

NPPES Registry Identity

NPI1063569135
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameDR. STACY KIM JOHNSTONCredential: PHD
Location Address4730 PALM AVE, 202La Mesa, CA 91941-5266
Mailing Address4730 Palm Ave Ste 202La Mesa, CA 91941-5244 · (619) 778-7215 · Fax (619) 328-9332
Phone(619) 778-7215
Fax(619) 328-9332
Sole ProprietorYes
Medical School CMSOtherGraduated 1998
Enumeration DateJanuary 4, 2007
Last NPPES UpdateAugust 19, 2013
✔ NPI 1063569135 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 · PSY17457
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.
4730 PALM AVE, La Mesa, CA 91941
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Other Identifiers 1

Medicare PINCP17457ACA

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Stacy Kim Johnston Phd is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1153395298
PECOS Enrollment IDI20040824000570
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Psychotherapy, 1 hour 90837
Psychotherapy is a therapeutic interaction or treatment between a trained professional and a patient. In a 1-hour session, you'll talk about your feelings, thoughts, and behaviors to help identify and manage mental health issues. This process aids in personal growth, healing, and improved well-being.
209 services16 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 91941 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$184.71 typical visit price
range $62.10 – $184.71
Typical copayment $46.17 (range $15.52 – $46.17)
Most-billed visit code 99205
Established Patient
$108.42 typical visit price
range $20.62 – $151.42
Typical copayment $27.10 (range $5.15 – $37.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ROSEANNE APRIL RODRIGUEZ LCSW
Social Worker (Clinical)
4730 PALM AVE
LA MESA, CA 91941
San Diego County (619) 317-0085

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 Stacy Johnston's NPI number?

The NPI number for Stacy Johnston is 1063569135. It was assigned to this individual provider in the NPPES registry on January 4, 2007.

Where is Stacy Johnston located?

Stacy Johnston practices at 4730 Palm Ave 202, La Mesa, CA 91941. The listed phone number is (619) 778-7215.

What is Stacy Johnston's specialty?

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

Is Stacy Johnston enrolled in Medicare?

Yes. Stacy Johnston is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Stacy Johnston was last updated on August 19, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.