Active NPI
Johnny Chin
- Peer Specialist
- Stockton, CA
National Provider Identifier
1013462670
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- Practice address
- 2414 Brandywine CT
Stockton, CA 95210-6752 - Phone
- (209) 406-4783
- NPI assigned
- Aug 23, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | CA | Primary |
Addresses
Primary practice location
2414 Brandywine CT
Stockton, CA 95210-6752
Mailing address
2291 W March LN Ste C101
Stockton, CA 95207-6669
Phone (209) 954-3000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473120000000",
"number": "1013462670",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2291 W MARCH LN STE C101",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952076669",
"telephone_number": "209-954-3000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2414 BRANDYWINE CT",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952106752",
"telephone_number": "209-406-4783"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHIN",
"first_name": "JOHNNY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-08-23",
"last_updated": "2016-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stockton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.