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Deactivated NPI 1619093903 Deactivated / Inactive NPI Female Practitioner

Dr. Debra A Johnson , PhD

Psychologist • Modesto, CA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Debra Johnson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date March 21, 2007
NPI Deactivation Date March 01, 2023
Total Practice Duration ~16 Years of Practice (2007 – 2023)

Professional Overview & Biography Verified Profile Summary

Dr. Debra Johnson, PhD was a registered Psychologist practicing in Modesto, CA. Throughout an active medical career spanning 16 years, Dr. Johnson provided care at the practice location at 615 15TH ST until profile deactivation on 2023-03-01.

Historical Medicare Part B clinical services included psychotherapy. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

615 15th St

Modesto, CA 953542510

Telephone 2095274682
Fax 2095247780
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist in Modesto, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 16.0 Yrs
State Avg: 24.2 Yrs
Regional Practice Density
25 Specialists

Practicing in Modesto, CA (7695 Statewide)

Telehealth Adoption Rate
8.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
1.5% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2019)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
90837 Psychotherapy, 60 minutes
151 13 $120.00 $118.18

Medical Specialties & State Licenses

Psychologist Primary Specialty

NUCC Taxonomy Code: 103T00000X

State License CA PSY6262

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Lawrence Shaddix

Marriage & Family Therapist

NPI 1508282286

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
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NPI Profile Deactivated March 01, 2023

Record deactivated on March 01, 2023

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Medical Taxonomy / Specialty Registered (Primary Specialty) January 14, 2023

Psychologist (License #PSY6262 in CA)

NPI Profile Active August 13, 2013

NPI status registered as active in NPPES database

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Updated Practice Location August 13, 2013

Registered at 615 15TH ST, MODESTO, CA 953542510 (Tel: 2095274682)

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Updated Business Mailing Address August 13, 2013

Registered at 615 15TH ST, MODESTO, CA 953542510 (Tel: 2095274682)

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Provider Name / Credentials Updated August 13, 2013

Recorded as DEBRA JOHNSON, PH.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) August 13, 2013

Psychologist (License #PSY6262 in CA)

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Initial NPI Registration & Enumeration March 21, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1619093903
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 21, 2007
Last Update: August 13, 2013
Deactivation Date: March 01, 2023

Mailing Address

615 15th St

Modesto, CA 953542510

Phone: 2095274682

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.