Sharon Lorraine Johnson, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY12494 Issued in CA

Practice address

1111 E. Herndon Ave.
Suite #306
Fresno, CA 93720-3100

Phone

(559) 440-0112

Fax

(559) 440-0114

NPI assigned

Sep 18, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Dec 9, 2015 through Dec 9, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1221696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221696000000",
    "number": "1427207018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 E HERNDON AVE",
            "address_2": "SUITE #306",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203100",
            "telephone_number": "559-440-0112",
            "fax_number": "559-440-0114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 E. HERNDON AVE.",
            "address_2": "SUITE #306",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203100",
            "telephone_number": "559-440-0112",
            "fax_number": "559-440-0114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SHARON",
        "middle_name": "LORRAINE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-18",
        "last_updated": "2008-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY12494",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "CA",
            "license": "PSY12494",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY12494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Quentina Olinthia Johnson
• Robert Wayne Johnson
• Romeo Kendall Johnson, MD
• Ryan C Johnson
• Shannon Johnson, M.A., CCC-SLP
• Shawn Johnson, DC
• Spencer Johnson, MD
• Theresa J Johnson, RN, IBCLC, RLC
• Tiffany Nicole Lynne Johnson
• Tracy Johnson, MD

• Clinical Psychologist in Fresno, CA
• Providers in Fresno, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2008; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.