Individual provider Active NPI

Marie P. Johnson, PSYCH TECH 37685

  • Licensed Psychiatric Technician
  • French Camp, CA
National Provider Identifier
1255127148
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Psychiatric TechnicianTaxonomy code 167G00000X
License
37685 Issued in CA
Practice address
7000 Michael Canlis Way
French Camp, CA 95231-9781
Phone
(209) 468-4400
NPI assigned
Apr 16, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Psychiatric Technician 167G00000X 37685 CA Primary

Addresses

Primary practice location

7000 Michael Canlis Way
French Camp, CA 95231-9781

Mailing address

3266 Larchmont Dr
Stockton, CA 95209-5192
Phone (209) 670-6578

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

LicenseStateTypeSpecialty
37685CAMDLicensed Psychiatric Technician

NPI Registry JSON

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

{
    "created_epoch": "1744761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1255127148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3266 LARCHMONT DR",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952095192",
            "telephone_number": "209-670-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 MICHAEL CANLIS WAY",
            "city": "FRENCH CAMP",
            "state": "CA",
            "postal_code": "952319781",
            "telephone_number": "209-468-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARIE",
        "middle_name": "P.",
        "name_prefix": "Mrs.",
        "credential": "PSYCH TECH 37685",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-16",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": "CA",
            "license": "37685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in French Camp, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2025; 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.