Candieda Lee-Denise Johnson

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

6945 Old Highway 53
Clearlake, CA 95422-9381

Phone

(707) 995-9523

NPI assigned

Aug 15, 2023

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Lake County Office of Education

  • Local Education Agency (LEA)
  • Clearlake, CA
  • NPI 1861820979
  NPD (past)

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

{
    "created_epoch": "1692057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1316720113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6945 OLD HIGHWAY 53",
            "city": "CLEARLAKE",
            "state": "CA",
            "postal_code": "954229381",
            "telephone_number": "707-995-9523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6945 OLD HIGHWAY 53",
            "city": "CLEARLAKE",
            "state": "CA",
            "postal_code": "954229381",
            "telephone_number": "707-995-9523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CANDIEDA",
        "middle_name": "LEE-DENISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-15",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Austin Jacquillard
• Jennifer a Dowalter MD a Professional Corporation
• Raymond Dean Jennings, MD
• Jeong Sik Park MD a Prof Corp
• JJ&R Emergency Medical Group of California, Inc.
• Elise Patricia Anne Jones
• Katarina Juhaszova, PA-C
• Volodymyr Karpa, M.D.
• Steven C Keech, CAS
• Elizabeth Kelly, PHARMD

• Case Manager/Care Coordinator in Clearlake, CA
• Providers in Clearlake, CA by specialty
• Case Manager/Care Coordinator in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; 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.