Tisa S Johnson

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

60 Gold Crest CT
Pittsburg, CA 94565-6500

Phone

(925) 267-2059

Fax

(925) 877-8446

NPI assigned

Mar 6, 2025

Last updated

Mar 6, 2025By the provider in NPPES

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jordan House of Umoja

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Pittsburg, CA
  • NPI 1083429278
  NPD

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

{
    "created_epoch": "1741219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1457159394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4850 VINEWOOD WAY",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945318126",
            "telephone_number": "925-497-2479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 GOLD CREST CT",
            "city": "PITTSBURG",
            "state": "CA",
            "postal_code": "945656500",
            "telephone_number": "925-267-2059",
            "fax_number": "925-877-8446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TISA",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-06",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jocelyn Parros Psychotherapy Services
• Jacqueline Ann Johal-Morales
• Britnae Termara Johnson
• Keith Johnson
• Mary Johnson
• Deneta Marie Jones-Udefi, LCSW
• Kimberly Anne Jones
• Jordan House of Umoja
• Betheny Jordan
• Cheryl Marie Jordan

• Community Health Worker in Pittsburg, CA
• Providers in Pittsburg, CA by specialty
• Community Health Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.