JACK W JOHNSON (NPI# 1548332570) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548332570 |
| Entity Type | Individual |
| Full Name | JACK W JOHNSON |
| Credential | MD |
| Practice Address |
12377 Lewis Street Suite #104 Garden Grove CA 92840-4691 |
| Practice Telephone | 7147031366 |
| Mailing Telephone | 7147031366 |
| Mailing Fax Number | 7147500464 |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
G21314 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093284382 | Jack Lee Johnson II | Counselor | 1680 North Fair Oaks, Pasadena, CA 91104 | 2018-11-16 |
| 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 |
| 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 |
12377 LEWIS STREET SUITE #104 |
| City | GARDEN GROVE |
| State | CA |
| Zip Code | 92840-4691 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295961381 | Grace Hutchinson | Marriage & Family Therapist | 12377 Lewis Street, Suite 206, Garden Grove, CA 92840-4692 | 2009-06-03 |
| 1285750703 | Patricia Phillips | Marriage & Family Therapist | 12377 Lewis Street, Suite 206, Garden Grove, CA 92840-4675 | 2007-03-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588283808 | Kimberly Gaeta | Behavioral Analyst | 123935 Lewis Street, Ste 202, Garden Grove, CA 92840 | 2020-04-16 |
| 1396397170 | Rosa Cortez | Behavior Technician | 12443 Lewis Street, #201, Garden Grove, CA 92840 | 2019-07-12 |
| 1376005934 | Sekboppa Sor | Nurse Practitioner | An Lanh Free Clinic, 10861 Acacia Pkwy., Garden Grove, CA 92840 | 2019-04-03 |
| 1346730116 | Vinh Le Tran | Pharmacist | 12666 Brookhurst St. Suite 110, Garden Grove, CA 92840 | 2018-05-16 |
| 1841715232 | Scott R. Blair | Physician Assistant | 12828 Harbor Blvd Ste 200, Garden Grove, CA 92840 | 2017-08-07 |
| 1881049492 | Carmen Keally | Dietitian, Registered | 12602 9th St, Garden Grove, CA 92840 | 2016-05-02 |
| 1548688732 | House Call Medical Associates, Inc. | Internal Medicine | 12865 Main St Ste 105, Garden Grove, CA 92840 | 2014-04-03 |
| 1851733059 | Carly Ann Wade | Marriage & Family Therapist | 12755 Brookhurst St. Ste 116, Garden Grove, CA 92840 | 2013-07-29 |
| 1003159864 | Priyal Shah Ohri | Dentist | 10602 Chapman Ave, Suite 200, Garden Grove, CA 92840 | 2013-03-30 |
| 1770853244 | Joseph Pham | Pharmacist | 12001 Euclid St., Garden Grove, CA 92840 | 2011-12-30 |
| Find all providers in zip 92840 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578636429 | Bum Soo Lee | Psychiatry & Neurology | 12511 Brookhurst St. Suite 200, Garden Grove, CA 92840 | 2006-11-16 |
| 1104914449 | Clayton Long Chieu Chau | Psychiatry & Neurology | 13071 Brookhurst Street,, Suite 180, Garden Grove, CA 92843 | 2006-10-11 |
| 1467093849 | Tony Tran D O Inc | Psychiatry & Neurology | 13075 Blackbird St, Garden Grove, CA 92843 | 2019-10-07 |
| 1235504564 | Psychfitness, Apmc | Psychiatry & Neurology | 12373 Lewis St, Suite 103, Garden Grove, CA 92840-4676 | 2015-12-11 |
| 1255402608 | John R Weinstein | Psychiatry & Neurology | 12373 Lewis St, Suite 103, Garden Grove, CA 92840-4676 | 2006-11-09 |
| 1972560605 | Ravinder P Singh | Psychiatry & Neurology | 12555 Garden Grove Blvd, #305, Garden Grove, CA 92843-1902 | 2006-04-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750982054 | Joseph Ashimedua Modestus | Psychiatry & Neurology | 22433 South Vermont Ave, Apt 412, Torrance, CA 90502-9050 | 2020-11-03 |
| 1659970333 | Flatow Medical Corporation | Psychiatry & Neurology | 4840 Mindora Dr, Torrance, CA 90505-2140 | 2020-10-22 |
| 1053910158 | Open Mind Mental Health Inc | Psychiatry & Neurology | 5241 Alzeda Dr, La Mesa, CA 91941-5726 | 2020-10-20 |
| 1831705383 | Joel A Badeaux, Md, A Professional Corp | Psychiatry & Neurology | 2135 Park Dr, Los Angeles, CA 90026-1919 | 2020-09-21 |
| 1730794223 | Margarita Alonso Md LLC | Psychiatry & Neurology | 4401 Manchester Ave Ste 101, Encinitas, CA 92024-4938 | 2020-09-10 |
| 1760095673 | Dana Np: Advanced Practice Psychiatric Nursing, Inc. | Psychiatry & Neurology | 9801 Olympic Dr, Huntington Beach, CA 92646-4848 | 2020-08-29 |
| 1730792102 | Oladapo Tomori | Psychiatry & Neurology | Ginger, 116 New Montgomery Street, Suite 500, San Francisco, CA 94105 | 2020-08-26 |
| 1326658204 | Michael Martyna | Psychiatry & Neurology | 401 Quarry Road, Room 2208, Stanford Neuropsychiatry Fellowship Program Department, Stanford, CA 94305-5723 | 2020-08-05 |
| 1568072767 | Capitol City Psychiatry | Psychiatry & Neurology | 300 Harding Blvd Ste 118, Roseville, CA 95678-2472 | 2020-08-03 |
| 1164031530 | Katherine Ann Valdivia | Psychiatry & Neurology | 710 Madison St # A, Watsonville, CA 95076-2702 | 2020-07-30 |
| Find all providers with the same taxonomy | ||||
| City | GARDEN GROVE |
| Zip Code | 92840 |
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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.