JACK LEE JOHNSON II (NPI# 1093284382) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093284382 |
| Entity Type | Individual |
| Full Name | JACK LEE JOHNSON II |
| Practice Address |
1680 North Fair Oaks Pasadena CA 91104 |
| Mailing Address |
1680 N Fair Oaks Ave Pasadena CA 91103-1642 |
| Practice Telephone | 2102410481 |
| Mailing Telephone | 6267980884 |
| Enumeration Date | 2018-11-16 |
| Last Update Date | 2018-11-16 |
| 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) |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881129419 | Jack Alston Johnson | Emergency Medicine | 2300 Lone Star Rd, Mansfield, TX 76063-8744 | 2017-04-20 |
| 1396063418 | Jack Simpson Johnson | General Practice | 979 Mt. Vernon Rd., Cookeville, TN 38501 | 2010-05-13 |
| 1295992030 | Jack Allen Johnson Jr. | Psychologist | 12469 Timberwood Dr, Walker, LA 70785-5743 | 2008-05-20 |
| 1548332570 | Jack W Johnson | Psychiatry & Neurology | 12377 Lewis Street, Suite #104, Garden Grove, CA 92840-4691 | 2006-11-14 |
| 1568570018 | Jack Lawrence Johnson | Marriage & Family Therapist | 3576 Arlington Ave, Suite 307, Riverside, CA 92506-3943 | 2006-08-25 |
| 1730699695 | Jack N Johnson | Naturopath | 5603 38th Ave Nw, Gig Harbor, WA 98335-8218 | 2017-10-05 |
| 1962638999 | Jack Frank Johnson IIi | Clinical Nurse Specialist | 724 Arden Ln, Suite 100, Rock Hill, SC 29732-2996 | 2009-06-04 |
| 1902912322 | Jack F Johnson Jr. | Ophthalmology | 1190 Summers Ave, Orangeburg, SC 29115-4922 | 2006-08-21 |
| 1801859996 | Jack Leegon Johnson Jr. | Family Medicine | 560 W Main St, Suite 100, Lewisville, TX 75057-3629 | 2006-04-10 |
| 1356316996 | Jack Johnson | Anesthesiology | 455 Sherman St, Ste 510, Denver, CO 80203-4400 | 2006-02-17 |
| Street Address |
1680 NORTH FAIR OAKS |
| City | PASADENA |
| State | CA |
| Zip Code | 91104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699257055 | Aqueelah Russell | Lactation Consultant, Non-RN | 855 N. Catalina Ave, Pasadena, CA 91104 | 2018-09-02 |
| 1053893529 | Jordann Ashley Stewart | Case Manager/Care Coordinator | 691 East Washington Blvd, Pasadena, CA 91104 | 2018-08-31 |
| 1942789706 | Elmer Caballero | Case Manager/Care Coordinator | 691 E Washington Blvd, Pasadena, CA 91104 | 2018-08-12 |
| 1649759648 | Orlando Javier Sava Jr. | Case Manager/Care Coordinator | 1395 E. Orange Grove Blvd, Pasadena, CA 91104 | 2018-08-09 |
| 1669923611 | Grandview Foundation, Inc. | Substance Abuse Rehabilitation Facility | 225 Grandview Street, Pasadena, CA 91104 | 2016-10-14 |
| 1255734166 | Linhua Wang-kim | Massage Therapist | 1028 N. Lake Ave., Suite 108c, Pasadena, CA 91104 | 2014-10-06 |
| 1477893782 | Med Tec Diagnostic Inc. | Clinic/Center | 1310 N. Mar Vista Unit 3, Pasadena, CA 91104 | 2013-02-22 |
| 1750631321 | Gordon Sheldall | Marriage & Family Therapist | 1495 N Lake Avenue, Pasadena, CA 91104 | 2012-09-11 |
| 1699024521 | Sherry Lynn Wait | Marriage & Family Therapist | 1495 N. Lake Ave., Pasadena, CA 91104 | 2012-09-06 |
| 1770832883 | Lucinda Doty Grush | Marriage & Family Therapist | 1495 N. Lake Ave, Pasadena, CA 91104 | 2012-09-05 |
| Find all providers in zip 91104 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356975593 | Robbie Davis | Counselor | 1710 Strawberry Rd Ste 300, Pasadena, TX 77502-2649 | 2020-02-26 |
| 1730649922 | Barrett Arthur Tollenger | Counselor | 2825 Mountain Road, Suite 204, Pasadena, MD 21122 | 2019-03-22 |
| 1689144271 | Cathy Haigis | Counselor | 2528 Mountain Rd.7204, Pasadena, MD 21122-7204 | 2018-11-27 |
| 1013407071 | Sean Patrick Comingore | Counselor | 1680 N. Fair Oaks Ave., Pasadena, CA 91103 | 2018-05-15 |
| 1639678287 | Sean C Velazco | Counselor | 1245 E. Walnut St., Pasadena, CA 91106 | 2018-02-09 |
| 1013415215 | Dedicato Treatment Center Inc | Counselor | 133 N Altadena Dr Ste 430, Pasadena, CA 91107-7344 | 2018-01-23 |
| 1306366604 | Joseph Anthony Zepeda | Counselor | 1680 N. Fair Oaks Avenue, Pasadena, CA 91103 | 2017-06-27 |
| 1922528769 | Calvin Hayes | Counselor | 135 W Washington Blvd, Pasadena, CA 91103-2563 | 2017-06-22 |
| 1518406545 | Kevin Cross | Counselor | 25 El Nido Ave Apt 5, Pasadena, CA 91107-4448 | 2017-02-23 |
| 1306385133 | Alan Ray Brown | Counselor | 225 Grandview St, Pasadena, CA 91104-2114 | 2017-02-13 |
| Find all providers in PASADENA | ||||
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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.