DR. SAMANTHA ARCHUSSACHAT KWON PSY.D.
NPI 1861630022
Psychologist - Clinical in Sacramento, CA

Q: What is Samantha Kwon's NPI number?

The NPI number for Samantha Kwon is 1861630022. It was assigned to this individual provider in the NPPES registry on January 27, 2009.

Q: What is Samantha Kwon's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Samantha Kwon was last updated on February 11, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since January 27, 2009PECOS Enrolled

2008 MORSE AVE, COMMONS BUILDING, SACRAMENTO, CA 95825(916) 973-7502(916) 973-7320 Get Directions Write a Review

NPPES record last updated: February 11, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Dr. Samantha Archussachat Kwon Psy.d. NPPES

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

DR. SAMANTHA ARCHUSSACHAT KWON PSY.D. (NPI 1861630022) is an individual clinical provider in Sacramento, California, licensed in California (PSY22089) and active in the NPI registry since January 2009. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1861630022

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameDR. SAMANTHA ARCHUSSACHAT KWONCredential: PSY.D.

Location Address2008 MORSE AVE, COMMONS BUILDINGSacramento, CA 95825-2135

Mailing Address2008 Morse Ave, Commons BuildingSacramento, CA 95825-2135 · (916) 973-7502 · Fax (916) 973-7320

Phone(916) 973-7502

Fax(916) 973-7320

Sole ProprietorYes

Enumeration DateJanuary 27, 2009

Last NPPES UpdateFebruary 11, 2022

✔ NPI 1861630022 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 · PSY22089

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.

2008 MORSE AVE, Sacramento, CA 95825

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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. Samantha Archussachat Kwon Psy.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95825 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.

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