Stacy Kim Johnston, PHD
Clinical Psychologist · La Mesa, CA
Stacy Kim Johnston, PHD is a clinical psychologist with a practice address in La Mesa, California, and NPI 1063569135, issued on Jan 4, 2007. Check the license (California PSY17457, as entered in NPPES) with the California board that licenses this profession; the Medicare figures below come from public CMS files.
- Name
- Stacy Kim Johnston
- Credential
- PHD
- Primary taxonomy
- Clinical Psychologist 103TC0700X
- License number
- PSY17457 CA
Self-reported in NPPES; status is on the state search - Practice location
- 4730 Palm Ave, La Mesa, CA 91941
- Phone
- (619) 778-7215
- Enumerated
- Jan 4, 2007
- Record last updated
- Aug 19, 2013 (not updated in 13 years: call before relying on the address or phone)
- Fax
- (619) 328-9332
- Medicare enrollment
- Enrolled (PECOS I20040824000570); accepts Medicare assignment
- Telehealth
- Offers telehealth (CMS)
- Entity
- Type 1 · individual
8 nearest clinical psychologist records → All 12,647 in California → Look up another NPI →
Also registered at 4730 Palm Ave
A shared address usually means a shared clinic or building; it does not show who employs whom.
- Roseanne Rodriguez, LCSWClinical Social Worker1568940740
Verify Stacy Kim Johnston in five checks
- 1IdentityNPI record in CMS NPPESNPI lookupConfirmed in NPPES
- 2LicenseActive license and public ordersWhich California board licenses this profession
Search for license PSY17457Check the board - 3Other statesLicenses and actions elsewhereDocInfo (FSMB)Not checked
- 4ExclusionsMedicare and Medicaid bansHHS-OIG exclusion listNot checked
- 5CertificationBoard certificationABMS AOA NCCPA AANPNot checked
Bills Medicare through 2 group practices
- Pacific Psychology Centers, ApcCarlsbad, CA
- Southern California Psychology Centers ApcSan Diego, CA
Source: CMS Doctors and Clinicians National Downloadable File (the group practices a clinician bills Medicare through) (data.cms.gov).
Stacy Kim Johnston among 12,647 clinical psychologist records in California
Stacy Kim Johnston, PHD is one of 12,647 clinical psychologist records with a practice address in California. 9% of them appear in a Medicare file (Part D prescribing, MIPS, Open Payments or Medicare group billing); this one does. Its NPI, issued in 2007, is newer than 20% of them.
- NPI issued2007 · 20% of these records are older, 57% newer
- In a Medicare fileYes · 9% of these records are
- In the CMS Doctors and Clinicians fileYes · 19% of these records are
- Graduated1998 · median 2006 among the 2,424 with a school on file
- Record last updated2013 · 63% of these records were not updated in five years or more
Source: CMS NPPES, file of Aug 9, 2026, every record with primary taxonomy 103TC0700X and a California practice address; Medicare files: CMS Part D Prescribers 2024, MIPS 2023, Open Payments 2024, Doctors and Clinicians (data.cms.gov).
35 clinical psychologist records list a practice address in La Mesa
They are 35 of the 2,168 NPPES records with a practice address in La Mesa, and 12,647 clinical psychologist records in California.
All 12,647 in California → Every provider in La Mesa → Clinical Psychologist nationwide →
The 8 clinical psychologist records with the nearest ZIP codes
- Carol Arpaci, PSY.D.La Mesa, CA 919411023296324
- John Bartholow, PH.D.La Mesa, CA 919411134247919
- Charles Bilbrey, PH.D.La Mesa, CA 919411598935116
- Darrell Broaddus, PH.D.La Mesa, CA 919411265616973
- Kristie Earnheart, PHDLa Mesa, CA 919411528257334
- William Higgins, PH.D.La Mesa, CA 919411366464810
- Sheldon Kramer, PHDLa Mesa, CA 919411508992702
- Idalia McGivern, PH.D.La Mesa, CA 919411609820398
Common questions
What is Stacy Kim Johnston, PHD's NPI number?
Stacy Kim Johnston, PHD's National Provider Identifier (NPI) is 1063569135, issued on Jan 4, 2007. An NPI identifies a provider in billing; it is not a license.
Where is Stacy Kim Johnston, PHD located?
The NPPES record lists a practice address at 4730 Palm Ave, La Mesa, CA, 91941. Phone: (619) 778-7215. Providers update this record themselves, so call before visiting.
How can I verify Stacy Kim Johnston, PHD's license?
NPPES lists California license number PSY17457, as entered by the provider. Search the California board that licenses this profession; the NPPES record confirms identity only.
Source: CMS National Plan and Provider Enumeration System (NPPES), file of Aug 9, 2026 (NPPES files on CMS.gov); NUCC Health Care Provider Taxonomy. Medicare files from data.cms.gov. An NPI identifies who bills; it is not a license.
Figures on PlainDoctor are read from the federal files each page names (CMS NPPES, Medicare Part D, MIPS, Open Payments; the HHS-OIG exclusion list only as counts) and from Census population estimates, with the file date shown beside them. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of Aug 9, 2026.