Lisa Marie Johnson, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY21584 Issued in CA

Practice address

747 52ND St
Psychiatry/Castlemont
Oakland, CA 94609-1809

Phone

(510) 428-3885

NPI assigned

Jul 12, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1114126810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2921 HAVENSCOURT BLVD",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946052024",
            "telephone_number": "510-209-4161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 52ND ST",
            "address_2": "PSYCHIATRY/CASTLEMONT",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946091809",
            "telephone_number": "510-428-3885"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "465 34th St Ste A",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946092815",
            "country_code": "US",
            "telephone_number": "510-239-3893",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-12",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY21584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lashanna Johnson, LVN
• Latunjia Monia Johnson
• Laurie Lya Johnson
• Lawanda Marie Johnson, MA
• Layvette Johnson
• Lora Margherita Johnson, RN,MS,PNP
• Madison Renee Johnson
• Maeleane Fritzgerald Johnson
• Mark A Johnson, MSW CANDIDATE
• Markishea Johnson

• Clinical Psychologist in Oakland, CA
• Providers in Oakland, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.