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DR. KIMBERLY NOELLE DICKSON PSYD
NPI 1285119768
Psychologist - Clinical in Oakdale, CA

Active since October 01, 2018Opted out of Medicare · through Oct 25, 2026
145 N 2ND AVE STE 8, OAKDALE, CA 95361(209) 840-9696 Get Directions Write a Review

NPPES record last updated: February 18, 2020. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Feb 18, 2020, Oct 1, 2018 (2 updates tracked since 2018).

About Dr. Kimberly Noelle Dickson Psyd NPPES

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

DR. KIMBERLY NOELLE DICKSON PSYD (NPI 1285119768) is an individual clinical provider in Oakdale, California, licensed in California (30316) and active in the NPI registry since October 2018. She has opted out of Medicare through October 25, 2026 and remains eligible to order and refer and maintains a secondary practice location in Concord.

NPPES Registry Identity

NPI1285119768
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameDR. KIMBERLY NOELLE DICKSONCredential: PSYD
Location Address145 N 2ND AVE STE 8Oakdale, CA 95361-3064
Mailing Address145 N 2nd Ave Ste 8Oakdale, CA 95361-3064 · (209) 840-9696
Phone(209) 840-9696
Sole ProprietorYes
Enumeration DateOctober 1, 2018
Last NPPES UpdateFebruary 18, 20202 updates tracked since enumeration
✔ NPI 1285119768 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 · 30316
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.
145 N 2ND AVE STE 8, Oakdale, CA 95361
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Secondary Practice Location 1

Location 12827 Concord BlvdConcord, CA 94519-2608 · Phone (209) 840-9696

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Kimberly Noelle Dickson Psyd 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 25, 2018 through October 25, 2026.

Opt-Out Effective DateOctober 25, 2018
Opt-Out In Effect ThroughOctober 25, 2026Opt-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 95361 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
$176.60 typical visit price
range $58.87 – $176.60
Typical copayment $44.15 (range $14.71 – $44.15)
Most-billed visit code 99205
Established Patient
$103.36 typical visit price
range $19.28 – $144.60
Typical copayment $25.84 (range $4.82 – $36.15)
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.

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 Kimberly Dickson's NPI number?

The NPI number for Kimberly Dickson is 1285119768. It was assigned to this individual provider in the NPPES registry on October 1, 2018.

Where is Kimberly Dickson located?

Kimberly Dickson practices at 145 N 2nd Ave Ste 8, Oakdale, CA 95361. The listed phone number is (209) 840-9696.

What is Kimberly Dickson's specialty?

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

Is Kimberly Dickson enrolled in Medicare?

No. Kimberly Dickson has opted out of Medicare through October 25, 2026. 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 Kimberly Dickson was last updated on February 18, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.