STACY KIM JOHNSTON PSYCHOLOGY, INC.
NPI 1316554322
Psychologist - Clinical in San Diego, CA

Q: What is Stacy Kim Johnston Psychology, Inc.'s NPI number?

The NPI number for Stacy Kim Johnston Psychology, Inc. is 1316554322. It was assigned to this organization in the NPPES registry on September 24, 2020.

Q: What is Stacy Kim Johnston Psychology, Inc.'s specialty?

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

Active since September 24, 2020

501 W BROADWAY STE 800, SAN DIEGO, CA 92101(619) 077-8072 Get Directions Write a Review

NPPES record last updated: September 24, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Stacy Kim Johnston Psychology, Inc. NPPES

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

STACY KIM JOHNSTON PSYCHOLOGY, INC. (NPI 1316554322) is a healthcare organization registered as a clinical in San Diego, California and active in the NPI registry since September 2020. The organization lists Stacy Johnston, Owner, as its authorized official.

NPPES Registry Identity

NPI1316554322

Entity TypeOrganization

Primary Taxonomy103TC0700X

Legal Business NameSTACY KIM JOHNSTON PSYCHOLOGY, INC.

Location Address501 W BROADWAY STE 800San Diego, CA 92101-3546

Mailing Address501 W Broadway Ste 800San Diego, CA 92101-3546 · (619) 077-8072

Phone(619) 077-8072

Organization SubpartNo

Authorized OfficialStacy JohnstonOwner · (619) 077-8072

Enumeration DateSeptember 24, 2020

NPPES CertifiedSeptember 24, 2020

✔ NPI 1316554322 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

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.

501 W BROADWAY STE 800, San Diego, CA 92101

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Stacy Kim Johnston Psychology, Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Stacy Kim Johnston Psychology, Inc., which bills Medicare for the services this clinician delivers.

Clinician (1)

Stacy Johnston, PHD

Clinical Psychologist

NPI 1063569135

4730 PALM AVE 202
La Mesa, CA 91941

(619) 778-7215

✔ PECOS✔ Accepts Medicare8.9 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Kim Johnston Psychology, Inc.'s NPI number?

The NPI number for Stacy Kim Johnston Psychology, Inc. is 1316554322. It was assigned to this organization in the NPPES registry on September 24, 2020.

Where is Stacy Kim Johnston Psychology, Inc. located?

Stacy Kim Johnston Psychology, Inc. is located at 501 W Broadway Ste 800, San Diego, CA 92101. The listed phone number is (619) 077-8072.

What is Stacy Kim Johnston Psychology, Inc.'s specialty?

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

Is Stacy Kim Johnston Psychology, Inc. enrolled in Medicare?

Yes. Stacy Kim Johnston Psychology, Inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Stacy Kim Johnston Psychology, Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Stacy Kim Johnston Psychology, Inc.. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Stacy Kim Johnston Psychology, Inc. was last updated on September 24, 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.