DR. JEANINE JOHNSON PSYD
NPI 1790187094
Psychologist in San Diego, CA

Active since September 18, 2014PECOS Enrolled
5060 SHOREHAM PL, SAN DIEGO, CA 92122(877) 840-6956(619) 383-6701 Get Directions Write a Review

NPPES record last updated: November 3, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Jeanine Johnson Psyd NPPES

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

DR. JEANINE JOHNSON PSYD (NPI 1790187094) is an individual psychologist in San Diego, California, licensed in California (29523) and active in the NPI registry since September 2014. She is enrolled in Medicare PECOS and is a graduate of Other (2012).

NPPES Registry Identity

NPI1790187094
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameDR. JEANINE JOHNSONCredential: PSYD
Location Address5060 SHOREHAM PLSan Diego, CA 92122-5903
Mailing AddressPo Box 601422San Diego, CA 92160-1422 · (877) 840-6956 · Fax (619) 383-6701
Fax(619) 383-6701
Sole ProprietorYes
Medical School CMSOtherGraduated 2012
Enumeration DateSeptember 18, 2014
Last NPPES UpdateNovember 3, 2025
NPPES CertifiedNovember 3, 2025
NPI 1790187094 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in CA · 29523
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
5060 SHOREHAM PL, San Diego, CA 92122

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. Jeanine Johnson Psyd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4789806696
PECOS Enrollment IDI20260213003263
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.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Marriage & Family Therapist
5060 SHOREHAM PL
SAN DIEGO, CA 92122
Psychologist (Clinical)
5060 SHOREHAM PL, 200
SAN DIEGO, CA 92122
Home Health
5060 SHOREHAM PL, SUITE 220
SAN DIEGO, CA 92122
Social Worker (Clinical)
5060 SHOREHAM PL
SAN DIEGO, CA 92122

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 Jeanine Johnson's NPI number?

The NPI number for Jeanine Johnson is 1790187094. It was assigned to this individual provider in the NPPES registry on September 18, 2014.

Where is Jeanine Johnson located?

Jeanine Johnson practices at 5060 Shoreham Pl, San Diego, CA 92122. The listed phone number is (877) 840-6956.

What is Jeanine Johnson's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Jeanine Johnson enrolled in Medicare?

Yes. Jeanine Johnson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jeanine Johnson was last updated on November 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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.