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DR. JOHNNA LEIGH MEDINA PHD
NPI 1306492236
Psychologist - Clinical in Palo Alto, CA

Active since August 15, 2019Opted out of Medicare · through Jul 1, 2027
401 QUARRY RD # MC5718, PALO ALTO, CA 94304(650) 497-4489 Get Directions Write a Review

NPPES record last updated: January 3, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 3, 2020, Aug 15, 2019 (2 updates tracked since 2019).

About Dr. Johnna Leigh Medina Phd NPPES

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

DR. JOHNNA LEIGH MEDINA PHD (NPI 1306492236) is an individual clinical provider in Palo Alto, California, licensed in California (31454) and active in the NPI registry since August 2019. She has opted out of Medicare through July 1, 2027.

NPPES Registry Identity

NPI1306492236
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameDR. JOHNNA LEIGH MEDINACredential: PHD
Location Address401 QUARRY RD # MC5718Palo Alto, CA 94304-1419
Mailing Address2491 24th AveSan Francisco, CA 94116-2336 · (818) 632-3941
Phone(650) 497-4489
Sole ProprietorNo
Enumeration DateAugust 15, 2019
Last NPPES UpdateJanuary 3, 20202 updates tracked since enumeration
✔ NPI 1306492236 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 · 31454
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.
401 QUARRY RD # MC5718, Palo Alto, CA 94304
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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. Johnna Leigh Medina Phd 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 July 1, 2021 through July 1, 2027.

Opt-Out Effective DateJuly 1, 2021
Opt-Out In Effect ThroughJuly 1, 2027Opt-out affidavits renew automatically every two years unless cancelled

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 Johnna Medina's NPI number?

The NPI number for Johnna Medina is 1306492236. It was assigned to this individual provider in the NPPES registry on August 15, 2019.

Where is Johnna Medina located?

Johnna Medina practices at 401 Quarry Rd # Mc5718, Palo Alto, CA 94304. The listed phone number is (650) 497-4489.

What is Johnna Medina's specialty?

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

Is Johnna Medina enrolled in Medicare?

No. Johnna Medina has opted out of Medicare through July 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Johnna Medina was last updated on January 3, 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.