Active NPI
Maurice D Johnson
- Addiction (Substance Use Disorder) Counselor
- Fair Oaks, CA
National Provider Identifier
1124666359
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- A021510116
- Practice address
- 8086 Orange Ave
Fair Oaks, CA 95628-5941 - Phone
- (949) 337-1439
- NPI assigned
- Dec 18, 2019
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | A021510116 | CA | Primary |
Addresses
Primary practice location
8086 Orange Ave
Fair Oaks, CA 95628-5941
Mailing address
2325 Mossy Bank Dr Apt 6
Sacramento, CA 95833-2383
Phone (916) 270-8899
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 |
|---|---|---|---|
| A021510116 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1576627200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718323200000",
"number": "1124666359",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2325 MOSSY BANK DR APT 6",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958332383",
"telephone_number": "916-270-8899"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8086 ORANGE AVE",
"city": "FAIR OAKS",
"state": "CA",
"postal_code": "956285941",
"telephone_number": "949-337-1439"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "MAURICE",
"middle_name": "D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-12-18",
"last_updated": "2024-06-14",
"certification_date": "2024-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "A021510116",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fair Oaks, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.