Rudolph Johnson Jr., CATC1

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Practice address

6537 Reflection Dr Apt 105
San Diego, CA 92124-3111

Phone

(619) 727-7797

NPI assigned

Oct 20, 2016

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1476921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476921600000",
    "number": "1124579545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6537 REFLECTION DR APT 105",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921243111",
            "telephone_number": "619-727-7797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6537 REFLECTION DR APT 105",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921243111",
            "telephone_number": "619-727-7797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "RUDOLPH",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "CATC1",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-20",
        "last_updated": "2016-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Terry Johnson
• Rochelle Johnson, LVN
• Ronald D. Johnson, DDS
• Rosalyn Michele Johnson, CRC
• Rosemarie Marshall Johnson, M.D.
• Russ-Em Johnson, RN, CCRN, CMC
• Russell K Johnson, CO
• Sandra Amy Johnson, L.C.S.W.
• Sara Johnson
• Sarah A Johnson, LVN/LPN/CPT

• Substance Abuse Rehabilitation Facility in San Diego, CA
• Providers in San Diego, CA by specialty
• Substance Abuse Rehabilitation Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.

Verify at the official NPI Registry.