DR. RAPHAEL GIDHARRY JOHNSON (NPI# 1295253953) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295253953 |
| Entity Type | Individual |
| Full Name | DR. RAPHAEL GIDHARRY JOHNSON |
| Credential | PH.D., LCSW |
| Practice Address |
1753 N. Country Ln. Pasadena CA 91107-1104 |
| Practice Telephone | 2137004324 |
| Practice Fax Number | 6267977064 |
| Mailing Telephone | 2137004324 |
| Mailing Fax Number | 6267977064 |
| Enumeration Date | 2017-09-01 |
| Last Update Date | 2017-09-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TA0400X |
Psychologist Specialization: Addiction (Substance Use Disorder) |
PSY24051 | CA | Behavioral Health & Social Service Providers |
| Street Address |
1753 N. COUNTRY LN. |
| City | PASADENA |
| State | CA |
| Zip Code | 91107-1104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801412002 | Kwasi Nkansa | Physical Medicine & Rehabilitation | 2585 East Washington Blvd, Pasadena, CA 91107 | 2020-06-23 |
| 1609402742 | H & S Hospice Care Inc | Hospice Care, Community Based | 2525 E Colordo Blvd Suite 109, Pasadena, CA 91107 | 2020-03-20 |
| 1013557115 | Cindy Phun | Pharmacist | 3383 E Foothill Blvd, Pasadena, CA 91107 | 2020-01-07 |
| 1184185548 | Preferred Home Health Services | Home Health | 40 N Atlandena Dr Suite 219, Pasadena, CA 91107 | 2019-03-28 |
| 1861973729 | Julia E Underwood | Doula | 2335-115 E. Colorado Blvd #339, Pasadena, CA 91107 | 2018-08-28 |
| 1982183166 | Melissa Castillo | Counselor | 26 S Kinneloa Ave, Pasadena, CA 91107 | 2018-08-09 |
| 1083109904 | Lourice Boutros | Optometrist | 3235 E Colorado Blvd Ste 101, Pasadena, CA 91107 | 2018-06-22 |
| 1902313026 | Cecily Brogdon | Marriage & Family Therapist | 2115 Lambert Drive, Pasadena, CA 91107 | 2018-01-10 |
| 1790204915 | Vanessa Nicole Contreras | Licensed Vocational Nurse | 36 S. Kinneiloa Ave., Pasadena, CA 91107 | 2017-09-19 |
| 1730614397 | Rita Mason | Behavioral Analyst | 890 S Rosemead Blvd, Ste 45, Pasadena, CA 91107 | 2017-04-20 |
| Find all providers in zip 91107 | ||||
| Taxonomy Code | 103TA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477573608 | Steven H. Moss | Psychologist | 595 E Colorado Blvd, Suite 802, Pasadena, CA 91101-2039 | 2006-07-20 |
| 1790213247 | Pasadena Clinical Group, A Psychology Corporation | Psychologist | 595 E Colorado Blvd Ste 428, Pasadena, CA 91101-2058 | 2017-05-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881293199 | Corinne Guerrero | Psychologist | 4820 Melrose Ave, Oakland, CA 94601-5346 | 2020-10-19 |
| 1326661331 | Dr Susan Shapiro Psychologist, Inc | Psychologist | 1647 S Hayworth Ave, Los Angeles, CA 90035-4513 | 2020-05-26 |
| 1326669011 | Northstar Detox & Rehab Center, LLC | Psychologist | 19500 Winifred St, Tarzana, CA 91356-3815 | 2020-05-04 |
| 1548891443 | Catalyst Recovery LLC | Psychologist | 10250 Constellation Blvd Ste 100, Los Angeles, CA 90067-6272 | 2020-01-29 |
| 1932765336 | Mischka Psychological PC | Psychologist | 4468 Phelan Rd, Phelan, CA 92371-4098 | 2019-05-13 |
| 1851955181 | Matthew Taylor | Psychologist | 27645 E Trail Ridge Way Apt 1007, Moreno Valley, CA 92555-3122 | 2019-04-23 |
| 1790249894 | Lags Spine and Sportscare Medical Centers, Inc. | Psychologist | 3751 E Shields Avenue, Fresno, CA 93726 | 2019-01-23 |
| 1639640766 | Lidia Janette Aguilar | Psychologist | 4958 Gabrielieno Ave, Oceanside, CA 92057-4434 | 2018-12-16 |
| 1215428230 | Chances Counseling Centers LLC | Psychologist | 2727 N Bristol St, Santa Ana, CA 92706 | 2018-05-24 |
| 1417402066 | Aldo Ramirez | Psychologist | 1402 W Juniper St, Oxnard, CA 93033-3321 | 2016-08-23 |
| Find all providers with the same taxonomy | ||||
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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.