Individual provider Active NPI

John Stanley Kinsman, PSYD

  • Psychologist
  • Patton, CA
National Provider Identifier
1740232487
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY16189 Issued in CA
Practice address
3102 East Highland Ave
Patton, CA 92369
Phone
(909) 425-7000
Fax
(909) 425-7520
NPI assigned
May 17, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY16189 CA Primary

Addresses

Primary practice location

3102 East Highland Ave
Patton, CA 92369

Mailing address

1600 9TH Street
Room 205 Mailstop 2-3
Sacramento, CA 95814-6414
Phone (916) 654-2431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200522000711 CA Practitioner - Clinical Psychologist 3971805573 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health Group Psychological Services IncGroup PAC ID 3870779622, 2 clinicians

Practice addresses (Care Compare)

8580 Utica Ave
Rancho Cucamonga, CA 91730-4870
Phone (909) 944-1717

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY16189CAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
State of California - Department of Developmental Services Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1740232487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 9TH STREET",
            "address_2": "ROOM 205 MAILSTOP 2-3",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958146414",
            "telephone_number": "916-654-2431",
            "fax_number": "916-654-3186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3102 EAST HIGHLAND AVE",
            "city": "PATTON",
            "state": "CA",
            "postal_code": "92369",
            "telephone_number": "909-425-7000",
            "fax_number": "909-425-7520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINSMAN",
        "first_name": "JOHN",
        "middle_name": "STANLEY",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY16189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Patton, CA

Sources for this page

Verify at the official NPI Registry.