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DR. KINA ANNETTE JOHNSON CLARK PH.D.
NPI 1326061813
Psychologist - Clinical in Rocklin, CA

Active since July 25, 2006PECOS Enrolled
3724 ATHERTON RD STE 100, ROCKLIN, CA 95765(916) 726-4030(916) 786-3080 Get Directions Write a Review

NPPES record last updated: June 15, 2024. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Jun 15, 2024, Mar 23, 2023 (2 updates tracked since 2023).

About Dr. Kina Annette Johnson Clark Ph.d. NPPES

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

DR. KINA ANNETTE JOHNSON CLARK PH.D. (NPI 1326061813) is an individual clinical provider in Rocklin, California, licensed in California (PSY16066) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS and is a graduate of Other (1996).

NPPES Registry Identity

NPI1326061813
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameDR. KINA ANNETTE JOHNSON CLARKCredential: PH.D.
Location Address3724 ATHERTON RD STE 100Rocklin, CA 95765-3717
Mailing Address1380 Lead Hill Blvd Ste 110Roseville, CA 95661-2997 · (916) 532-0996 · Fax (916) 786-3080
Phone(916) 726-4030
Fax(916) 786-3080
Sole ProprietorYes
Medical School CMSOtherGraduated 1996
Enumeration DateJuly 25, 2006
Last NPPES UpdateJune 15, 20242 updates tracked since enumeration
NPPES CertifiedApril 8, 2024
✔ NPI 1326061813 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 · PSY16066
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.
3724 ATHERTON RD STE 100, Rocklin, CA 95765
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Other Names 1

Other Name (5)Dr. Kina Annette Clark Ph.d.

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kina Annette Johnson Clark Ph.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8729139837
PECOS Enrollment IDI20090701000429
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Psychotherapy, 1 hour 90837
Psychotherapy is a therapeutic interaction or treatment between a trained professional and a patient. In a 1-hour session, you'll talk about your feelings, thoughts, and behaviors to help identify and manage mental health issues. This process aids in personal growth, healing, and improved well-being.
485 services17 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95765 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
$180.85 typical visit price
range $60.44 – $180.85
Typical copayment $45.21 (range $15.11 – $45.21)
Most-billed visit code 99205
Established Patient
$105.95 typical visit price
range $19.88 – $148.15
Typical copayment $26.48 (range $4.97 – $37.03)
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 Kina Johnson Clark's NPI number?

The NPI number for Kina Johnson Clark is 1326061813. It was assigned to this individual provider in the NPPES registry on July 25, 2006. The provider is also known as Dr. Kina Annette Clark Ph.D..

Where is Kina Johnson Clark located?

Kina Johnson Clark practices at 3724 Atherton Rd Ste 100, Rocklin, CA 95765. The listed phone number is (916) 726-4030.

What is Kina Johnson Clark's specialty?

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

Is Kina Johnson Clark enrolled in Medicare?

Yes. Kina Johnson Clark is registered in the Medicare PECOS enrollment system.

What insurance does Kina Johnson Clark accept?

Health plans from Providence Health Plan list Kina Johnson Clark as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kina Johnson Clark was last updated on June 15, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.