Active NPI
Christine Elizabeth Johnson, PH.D.
- Clinical Psychologist
- Bernalillo, NM
National Provider Identifier
1447346598
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 547
- Practice address
- 224 N Camino del Pueblo
Bernalillo, NM 87004-6146 - Phone
- (505) 404-5727
- Fax
- (505) 867-7891
- NPI assigned
- Oct 5, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 547 | NM | Primary |
Addresses
Primary practice location
224 N Camino del Pueblo
Bernalillo, NM 87004-6146
Mailing address
PO Box 1251
Corrales, NM 87048-1251
Phone (505) 850-4268
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| V6726 | Medicaid | NM |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 547 | NM | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1447346598",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1251",
"city": "CORRALES",
"state": "NM",
"postal_code": "870481251",
"telephone_number": "505-850-4268",
"fax_number": "505-867-7891"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "224 N CAMINO DEL PUEBLO",
"city": "BERNALILLO",
"state": "NM",
"postal_code": "870046146",
"telephone_number": "505-404-5727",
"fax_number": "505-867-7891"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "CHRISTINE",
"middle_name": "ELIZABETH",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NM",
"license": "547",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "V6726",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bernalillo, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.