JENNA GABRIELLE JOHNSON PSY D
NPI 1710969191
Psychologist - Clinical in Sonora, CA
About Jenna Gabrielle Johnson Psy D NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JENNA GABRIELLE JOHNSON PSY D (NPI 1710969191) is an individual clinical provider in Sonora, California, licensed in California (PSY18496) and active in the NPI registry since November 2005. She is enrolled in Medicare PECOS and maintains a secondary practice location in Valley Springs.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jenna Gabrielle Johnson Psy D is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Jenna Johnson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Jamestown, CA 95327
- Reassigned Medicare billing, Texas enrollment
- 17 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 95370 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Jenna Johnson's NPI number?
The NPI number for Jenna Johnson is 1710969191. It was assigned to this individual provider in the NPPES registry on November 19, 2005.
Where is Jenna Johnson located?
Jenna Johnson practices at 230 S Shepherd St Ste D, Sonora, CA 95370. The listed phone number is (209) 432-3616.
What is Jenna Johnson's specialty?
The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.
Is Jenna Johnson enrolled in Medicare?
Yes. Jenna Johnson is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Jenna Johnson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jenna Johnson reassigns Medicare benefits to Mathiesen Memorial Health Clinic (Jamestown, 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 Jenna Johnson'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 Jenna Johnson was last updated on December 4, 2023. 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.
# Jenna Gabrielle Johnson, PSY D · NPI 1710969191
Clinical provider in Sonora, California. Individual provider, active in the CMS NPPES registry since November 19, 2005.
## Identity
- **NPI:** 1710969191 (Entity type: Individual)
- **Enumerated:** November 19, 2005
- **Primary specialty:** Psychologist - Clinical · taxonomy 103TC0700X
- **State license:** PSY18496 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 230 S SHEPHERD ST STE D, Sonora, CA 95370-5076
- **Phone:** (209) 432-3616
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Mathiesen Memorial Health Clinic (NPI 1255595484, Jamestown, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 4, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1710969191) · Data from the CMS NPPES public registry.