REILLY JOHNSON (NPI# 1073973582) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073973582 |
| Entity Type | Individual |
| Full Name | REILLY JOHNSON |
| Credential | CADC-I |
| Practice Address |
151 W Mission St 100 San Jose CA 95110-1713 |
| Practice Telephone | 4085354002 |
| Practice Fax Number | 4082807201 |
| Mailing Telephone | 4085354002 |
| Mailing Fax Number | 4082807201 |
| Enumeration Date | 2016-02-25 |
| Last Update Date | 2016-02-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
CI5201215 | CA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | CCAPP | CI5201215 | 01 |
| Street Address |
151 W MISSION ST 100 |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95110-1713 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487785549 | Marian Lamon | Rehabilitation Counselor | 151 W Mission St, San Jose, CA 95110-1713 | 2007-03-08 |
| 1235754698 | Michael Wong | Pharmacist | 151 W Mission St, San Jose, CA 95110-1713 | 2020-06-11 |
| 1831745892 | Briana Mcalister | Social Worker | 151 W Mission St, San Jose, CA 95110-1713 | 2019-08-15 |
| 1174014252 | Bruce Charles Nickles | Marriage & Family Therapist | 151 W Mission St, San Jose, CA 95110-1713 | 2018-05-23 |
| 1396248480 | Horizon Services, Incorporated | Community/Behavioral Health | 151 W Mission St, San Jose, CA 95110-1713 | 2018-03-14 |
| 1710429535 | County of Santa Clara | Community/Behavioral Health | 151 W Mission St, Ste A1 Wing A, San Jose, CA 95110-1713 | 2016-11-10 |
| 1225481427 | Michael Parker | Rehabilitation Counselor | 151 W Mission St, San Jose, CA 95110-1713 | 2016-07-22 |
| 1093161689 | Ryan Forward | Peer Specialist | 151 W Mission St, Suite 100, San Jose, CA 95110-1713 | 2016-05-12 |
| 1801291356 | County of Santa Clara | Community/Behavioral Health | 151 W Mission St, A1 Wing-east, San Jose, CA 95110-1713 | 2014-10-27 |
| 1932509064 | Virginia Ballantyne | Social Worker | 151 W Mission St, San Jose, CA 95110-1713 | 2014-08-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356876064 | Clarissa Sherrill Chan | Physician Assistant | 685 Coleman Ave Ste 20, San Jose, CA 95110 | 2017-05-01 |
| 1366895666 | Lifemoves - Autumn Satellite Clinic | Case Management | 263 N Autumn St, San Jose, CA 95110 | 2016-07-21 |
| 1487067278 | Catholic Charities of Scc | Community/Behavioral Health | 921 S 1st St, San Jose, CA 95110 | 2014-06-09 |
| 1871855916 | Act for Mental Health, Inc | Psychologist | 441 Park Avenue, San Jose, CA 95110 | 2012-06-14 |
| 1730451238 | Jackson Huang | Nurse Practitioner | 685 Coleman Ave, San Jose, CA 95110 | 2012-01-31 |
| 1104000405 | Kaitlyn Brownell | Case Manager/Care Coordinator | 150-a S. Autumn St., San Jose, CA 95110 | 2007-12-21 |
| 1760685218 | Sharon Iwen Wang | Psychologist | 2033 Gateway Pl Fl 5, San Jose, CA 95110 | 2007-06-11 |
| 1528192036 | Wanda Broadie Alexander | Social Worker | 441 Park Ave, San Jose, CA 95110 | 2007-03-15 |
| 1750442208 | Mario Ricardo Ponce | Counselor | 70 West Hedding Street, County of Santa Clara, San Jose, CA 95110 | 2006-12-12 |
| 1467426882 | Lannie S. Zarate-reyes D.d.s., Inc. | Dentist | 579-10 Coleman Avenue, San Jose, CA 95110 | 2006-02-14 |
| Find all providers in zip 95110 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104451194 | Arthur Warren Hall | Counselor | 298 A Bernal Road, San Jose, CA 95119 | 2020-03-10 |
| 1609412469 | Cathy Logie | Counselor | 2682 Coit Dr, San Jose, CA 95124-1611 | 2019-11-26 |
| 1831692722 | Nicholas Jordon Thompson | Counselor | 2218 North First Street, San Jose, CA 95131 | 2018-03-16 |
| 1376045591 | Michael Li | Counselor | 2202 N 1st St, San Jose, CA 95131-2007 | 2018-03-03 |
| 1104338805 | Sydney Louise Tai | Counselor | 1370 Tully Rd Ste 301, San Jose, CA 95122-3056 | 2017-11-02 |
| 1932624871 | Linh Tuyet Vong | Counselor | 760 Pelleas Ln, San Jose, CA 95127-1030 | 2017-08-12 |
| 1760907273 | Marina Marie Mendonca | Counselor | 650 S. Bascom Ave, San Jose, CA 95128 | 2017-08-04 |
| 1952825911 | Robert Martin Thomas | Counselor | 950 Julian St, San Jose, CA 95122 | 2017-08-01 |
| 1386171221 | Mia Yvone Jaurigue | Counselor | 151 W Mission St # A1, San Jose, CA 95110-1713 | 2017-05-22 |
| 1396296307 | Andres Lujan Jr. | Counselor | 1867 Senter Rd, San Jose, CA 95112-2527 | 2016-10-14 |
| Find all providers in SAN JOSE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.