Individual provider Active NPI

Johnny Josiah Meehan, LCSW

  • Clinical Social Worker
  • Sonora, CA
National Provider Identifier
1003103458
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
137651 Issued in CA
Practice address
13975 Mono Way Ste J
Sonora, CA 95370-2824
Phone
(209) 588-4640
NPI assigned
Jul 6, 2011
Last updated
Apr 21, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW-42126 ID
Clinical Social Worker 1041C0700X 137651 CA Primary

Addresses

Primary practice location

13975 Mono Way Ste J
Sonora, CA 95370-2824

Mailing address

PO Box 939
Angels Camp, CA 95222-0939

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220601000915 ID Practitioner - Clinical Social Worker 1355729518
I20260501000190 TX Practitioner - Clinical Social Worker 1355729518 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

13975 Mono Way
Suite J
Sonora, CA 95370-2824
Phone (209) 533-9600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
137651CAMDClinical Social Worker
LCSW-42126IDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Clinics, Inc. Clinical CurrentSince Apr 26, 2022 Accepting new patients
Community Health Clinics, Inc. Current Accepting new patients
Community Health Clinics, Inc. CurrentSince Apr 26, 2022 Accepting new patients
Youth for Change Past Accepting new patients

Locations

300 S 23rd St
Boise, ID 83702
Phone (208) 344-3512

6855 W Fairview Ave
Boise, ID 83704

524 Cleveland Blvd
Ste 180
Caldwell, ID 83605
Phone (208) 454-2996

150 2nd St
Melba, ID 83641
Phone (208) 495-1011

3115 E Florence Dr
Meridian, ID 83642
Phone (208) 378-4288

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14315/brand/1/csg/1/fhir/r4

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1003103458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 939",
            "city": "ANGELS CAMP",
            "state": "CA",
            "postal_code": "952220939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13975 MONO WAY STE J",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953702824",
            "telephone_number": "209-588-4640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEEHAN",
        "first_name": "JOHNNY",
        "middle_name": "JOSIAH",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-06",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-42126",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "137651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sonora, CA

Sources for this page

Verify at the official NPI Registry.