SAMUEL LEWIS KIMBLES PL.D. PSYCHOLOGY
NPI 1184957730
Psychologist - Clinical in Santa Rosa, CA

Active since September 15, 2009Opted out of Medicare · through Oct 1, 2027
818 CHERRY STREET, SANTA ROSA, CA 95404(707) 544-6647 Get Directions Write a Review

NPPES record last updated: September 15, 2009. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Samuel Lewis Kimbles Pl.d. Psychology NPPES

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

SAMUEL LEWIS KIMBLES PL.D. PSYCHOLOGY (NPI 1184957730) is an individual clinical provider in Santa Rosa, California, licensed in California (PSY3687) and active in the NPI registry since September 2009. He has opted out of Medicare through October 1, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1184957730
Entity TypeIndividualMale
Primary Taxonomy103TC0700X
Provider Legal NameSAMUEL LEWIS KIMBLESCredential: PL.D. PSYCHOLOGY
Location Address818 CHERRY STREETSanta Rosa, CA 95404
Mailing Address818 Cherry StreetSanta Rosa, CA 95404 · (707) 544-6647 · Fax (707) 544-6672
Sole ProprietorNo
Enumeration DateSeptember 15, 2009
NPI 1184957730 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License Licensed in CA · PSY3687
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.

Also ListedPsychologist · Clinical Child & AdolescentTaxonomy 103TC2200X · License PSY3687 (CA)
818 CHERRY STREET, Santa Rosa, CA 95404

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Opted out of Medicare

Samuel Lewis Kimbles Pl.d. Psychology 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 October 1, 2015 through October 1, 2027.

Opt-Out Effective DateOctober 1, 2015
Opt-Out In Effect ThroughOctober 1, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95404 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
$187.01 typical visit price
range $63.04 – $187.01
Typical copayment $46.75 (range $15.76 – $46.75)
Most-billed visit code 99205
Established Patient
$109.88 typical visit price
range $21.02 – $153.40
Typical copayment $27.47 (range $5.25 – $38.35)
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.

Marriage & Family Therapist
818 CHERRY STREET
SANTA ROSA, CA 95404

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 Samuel Kimbles's NPI number?

The NPI number for Samuel Kimbles is 1184957730. It was assigned to this individual provider in the NPPES registry on September 15, 2009.

Where is Samuel Kimbles located?

Samuel Kimbles practices at 818 Cherry Street, Santa Rosa, CA 95404. The listed phone number is (707) 544-6647.

What is Samuel Kimbles's specialty?

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

Is Samuel Kimbles enrolled in Medicare?

No. Samuel Kimbles has opted out of Medicare through October 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.

When was this NPI record last updated?

The NPPES record for Samuel Kimbles was last updated on September 15, 2009. NPI Profile syncs with the weekly NPPES data releases published by CMS.