Active NPI
Evelyn M Johnson, DO
- Psychiatry Physician
- San Clemente, CA
National Provider Identifier
1346254869
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 20A5663
- Practice address
- 53 Calle Akelia
San Clemente, CA 92673-7038 - Phone
- (949) 584-2985
- NPI assigned
- Jul 28, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 20A5663 | CA | Primary |
Addresses
Primary practice location
53 Calle Akelia
San Clemente, CA 92673-7038
Mailing address
53 Calle Akelia
San Clemente, CA 92673-7038
Phone (949) 584-2985
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00AX56630 | Other | CA | MEDI CAL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jun 9, 2025 through Jun 9, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A5663 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744934400000",
"number": "1346254869",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "53 CALLE AKELIA",
"city": "SAN CLEMENTE",
"state": "CA",
"postal_code": "926737038",
"telephone_number": "949-584-2985"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "53 CALLE AKELIA",
"city": "SAN CLEMENTE",
"state": "CA",
"postal_code": "926737038",
"telephone_number": "949-584-2985"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "EVELYN",
"middle_name": "M",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-28",
"last_updated": "2025-04-18",
"certification_date": "2025-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "20A5663",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDI CAL",
"identifier": "00AX56630",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Clemente, CA
- John Di Saia MD., Inc.
- John R Gorny MD Inc
- John Vogt Chiropractic Inc.
- Johnson & Rollolazo, a Professional Corporation (Talega Coast Dentistry)
- Eric Scott Johnson, DDS
- James Robert Johnson, M.D.
- Martin Arthur Johnson, M.D.
- Raymon Tyler Johnson, D.C.
- Dale R. Johnstone, D.D.S.
- Rima Danielle Jomaa, MA, MFT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.