JEANNE DIANE KIMURA PSYD
NPI 1205139268
Psychologist - Clinical in Costa Mesa, CA
About Jeanne Diane Kimura Psyd NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JEANNE DIANE KIMURA PSYD (NPI 1205139268) is an individual clinical provider in Costa Mesa, California, licensed in California (PSY33292) and active in the NPI registry since December 2010. She is enrolled in Medicare PECOS and is a graduate of Other (2015).
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Jeanne Diane Kimura Psyd 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.
Medicare Billing Reassignment
Medicare enrollment records show Jeanne Kimura reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Hoopa, CA 95546
- Reassigned Medicare billing, California enrollment
- Medicare enrollment name: Kima-W Medical Center
- 33 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 92627 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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 Jeanne Kimura's NPI number?
The NPI number for Jeanne Kimura is 1205139268. It was assigned to this individual provider in the NPPES registry on December 14, 2010.
Where is Jeanne Kimura located?
Jeanne Kimura practices at 370 Avocado St Apt 7, Costa Mesa, CA 92627. The listed phone number is (714) 469-6700.
What is Jeanne Kimura's specialty?
The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.
Is Jeanne Kimura enrolled in Medicare?
Yes. Jeanne Kimura 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.
Which organization bills Medicare for Jeanne Kimura's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jeanne Kimura reassigns Medicare benefits to K'ima:w Medical Center (Hoopa, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jeanne Kimura's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Jeanne Kimura was last updated on June 6, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Jeanne Diane Kimura, PSYD · NPI 1205139268
Clinical provider in Costa Mesa, California. Individual provider, active in the CMS NPPES registry since December 14, 2010.
## Identity
- **NPI:** 1205139268 (Entity type: Individual)
- **Enumerated:** December 14, 2010
- **Primary specialty:** Psychologist - Clinical · taxonomy 103TC0700X
- **State license:** PSY33292 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 370 AVOCADO ST APT 7, Costa Mesa, CA 92627-1671
- **Phone:** (714) 469-6700
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** K'ima:w Medical Center (NPI 1306904222, Hoopa, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2015
## Record status
- **NPPES last updated:** June 6, 2022
---
Source: [NPI Profile](https://npiprofile.com/npi/1205139268) · Data from the CMS NPPES public registry.