Jacob Johnson, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A184926 Issued in CA

Practice address

225 37TH Ave
San Mateo, CA 94403-4324

Phone

(650) 573-2222

NPI assigned

May 10, 2021

Sex

Male

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jjohnson20053@smch.direct-ci.com

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.

• County of San Mateo

  • Public Health or Welfare Agency
  • San Mateo, CA
  • NPI 1306907928
  Medicare reassignment NPD
• County of San Mateo

  • Multi-Specialty Clinic/Center
  • San Mateo, CA
  • NPI 1679642326
  Medicare reassignment NPD
• County of San Mateo

  • Adolescent and Children Mental Health Clinic/Center
  • San Bruno, CA
  • NPI 1215029087
  NPD
• County of San Mateo

  • Community/Behavioral Health Agency
  • Redwood City, CA
  • NPI 1528432481
  NPD

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

{
    "created_epoch": "1620604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681603200000",
    "number": "1194309724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1048 CONTINENTALS WAY APT 36",
            "city": "BELMONT",
            "state": "CA",
            "postal_code": "940023188",
            "telephone_number": "503-804-0815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 37TH AVE",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944034324",
            "telephone_number": "650-573-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JACOB",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-10",
        "last_updated": "2023-04-16",
        "certification_date": "2023-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A184926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Luu
• Ann L Johnson, MD
• David Dean Johnson, LPCC
• Empris Johnson
• Holly Johnson, WHNP
• Jasmine Johnson
• Jessica S Johnson
• Linda Johnson, LMFT, LAADC
• Linda Lynette Johnson
• Lucretia Johnson

• Psychiatry Physician in San Mateo, CA
• Providers in San Mateo, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.