Active NPI
Krystal Johnson, LCSW
- Social Worker
- Fairfield, CA
National Provider Identifier
1114386018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 70036
- Practice address
- 4820 Business Center Dr
Fairfield, CA 94534-1696 - Phone
- (707) 977-8635
- NPI assigned
- Feb 19, 2016
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 70036 | CA | Primary |
Addresses
Primary practice location
4820 Business Center Dr
Fairfield, CA 94534-1696
Mailing address
1072 View Dr
El Sobrante, CA 94803-1250
Phone (510) 253-4342
Other practice location 1
2310 1st St
Napa, CA 94559-2239
Phone (707) 977-8635
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 70036 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aldea, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Napa, CA
- NPI 1386809911
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1455840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1680825600000",
"number": "1114386018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1072 VIEW DR",
"city": "EL SOBRANTE",
"state": "CA",
"postal_code": "948031250",
"telephone_number": "510-253-4342"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4820 BUSINESS CENTER DR",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945341696",
"telephone_number": "707-977-8635"
}
],
"practiceLocations": [
{
"address_1": "2310 1st St",
"address_purpose": "LOCATION",
"city": "Napa",
"state": "CA",
"postal_code": "945592239",
"country_code": "US",
"telephone_number": "707-977-8635",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNSON",
"first_name": "KRYSTAL",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-02-19",
"last_updated": "2023-04-07",
"certification_date": "2023-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "70036",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.