Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kim Ann Cornish, PHD

Individual provider Clinical Psychologist · NPI 1922176551

Kim Ann Cornish, PHD is a Clinical Psychologist in Elk Grove, California. Qualified in 2001, 25 years ago. Practices as a sole proprietor, works from 2 locations and accepts Medicare assignment. Licensed in California.

Years since qualifying
25
Licensed in
CA
In the registry since
2006
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

8788 Elk Grove Blvd Bldg 2 Ste F
Elk Grove, CA 95624
Phone: (530) 514-1066
Fax: (916) 687-3140
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 8920 Emerald Park Dr, Elk Grove, CA 95624-2380 — (530) 514-1066

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence PSY18648 (CA)

Record details

NPI number1922176551
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHD
Sole proprietorYes
NPI enumeratedDecember 1, 2006
Last updated in NPPESMay 14, 2025
Certification dateMay 14, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2001 (25 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Elk Grove