Individual provider Active NPI

Jamie Johnson, RN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Fairfield, CA
National Provider Identifier
1215583919
Registry record updated Jan 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95035795 Issued in CA
Practice address
4820 Business Center Dr Ste 210
Fairfield, CA 94534-1696
Phone
(707) 224-8266
NPI assigned
Aug 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95035795 CA Primary
Registered Nurse 163W00000X 95343775 CA

Addresses

Primary practice location

4820 Business Center Dr Ste 210
Fairfield, CA 94534-1696

Mailing address

PO Box 841
Napa, CA 94559-0841

Other practice location 1

2455 Bennett Valley Rd Ste B209
Santa Rosa, CA 95404-5669
Phone (707) 224-8266

Other practice location 2

2310 1st St
Napa, CA 94559-2239
Phone (707) 224-8266

Other practice location 3

2681 28th Ave
San Francisco, CA 94116-2912
Phone (415) 681-3211

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260209002051 CA Practitioner - Nurse Practitioner 6709365927 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of California, San Francisco School of Medicine, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2100 Powell St
Emeryville, CA 94608-1826

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
95343775CAMDRegistered Nurse
95035795CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - Psychiatry PC CurrentSince Feb 1, 2026 Accepting new patients
Cep America - Psychiatry PC CurrentSince Feb 1, 2026 Accepting new patients
Aldea, Inc PastSince Feb 12, 2023 Accepting new patients
Aldea Inc PastSince Feb 8, 2023 Accepting new patients
Aldea, Inc. PastSince Feb 4, 2024 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1601 Ygnacio Valley Rd
Walnut Creek, CA 94598
Phone (925) 295-1545

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1566086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768694400000",
    "number": "1215583919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 841",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945590841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4820 BUSINESS CENTER DR STE 210",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945341696",
            "telephone_number": "707-224-8266"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2455 Bennett Valley Rd Ste B209",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954045669",
            "country_code": "US",
            "telephone_number": "707-224-8266",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2310 1st St",
            "address_purpose": "LOCATION",
            "city": "Napa",
            "state": "CA",
            "postal_code": "945592239",
            "country_code": "US",
            "telephone_number": "707-224-8266",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2681 28th Ave",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941162912",
            "country_code": "US",
            "telephone_number": "415-681-3211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JAMIE",
        "credential": "RN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-18",
        "last_updated": "2026-01-18",
        "certification_date": "2026-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95035795",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95343775",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

Verify at the official NPI Registry.