Individual provider Active NPI

Asher Johnson, PHD

  • Clinical Psychologist
  • San Diego, CA
National Provider Identifier
1073876017
Registry record updated Oct 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY33666 Issued in CA
Practice address
480 Alta Rd
San Diego, CA 92179-0001
Phone
(619) 495-2252
NPI assigned
Jun 22, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY33666 CA
Forensic Psychologist 103TF0200X PSY33666 CA
Clinical Psychologist 103TC0700X PSY33666 CA Primary

Addresses

Primary practice location

480 Alta Rd
San Diego, CA 92179-0001

Mailing address

480 Alta Rd
San Diego, CA 92179-0001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20230228003188 CA Practitioner - Clinical Psychologist 5496128134 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY33666CAMDClinical Psychologist
33666CAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PC Mental Health CurrentSince Jan 29, 2023 Accepting new patients
Asher I Johnson PHD Prof Corp Psychologist Current Accepting new patients
Community Research Foundation Inc Past Accepting new patients
Community Research Foundation Inc Clinical Past Accepting new patients

Locations

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1340323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666396800000",
    "number": "1073876017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 ALTA RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921790001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 ALTA RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921790001",
            "telephone_number": "619-495-2252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ASHER",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-22",
        "last_updated": "2022-10-22",
        "certification_date": "2022-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY33666",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "CA",
            "license": "PSY33666",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY33666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.