Stacey B Johnston, MSCPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

304862 Issued in CA

Practice address

6101 Bollinger Canyon Rd Ste 110
San Ramon, CA 94583-5106

Phone

(925) 222-5446

NPI assigned

Sep 23, 2009

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)

Enrolled

State licenses

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.

• Breakthrough Physical Therapy Inc

  • Physical Therapist
  • Sunnyvale, CA
  • NPI 1053320325
  NPD (past)

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

{
    "created_epoch": "1253664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715299200000",
    "number": "1548594518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 BOLLINGER CANYON RD STE 110",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945835106",
            "telephone_number": "925-222-5446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6101 BOLLINGER CANYON RD STE 110",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945835106",
            "telephone_number": "925-222-5446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "STACEY",
        "middle_name": "B",
        "name_prefix": "Ms.",
        "credential": "MSCPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-23",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "304862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Jo Johnson, LCSW
• Megan Johnson, PHD
• Susan B Johnson, NNP
• Terrill Christopher Johnson
• Zenda Nicole Johnson, AMFT
• Jayla A Jones
• Jerrel D Jones
• Sasha L Jones
• Saydie A Jones
• Tianna Jones

• Physical Therapist in San Ramon, CA
• Providers in San Ramon, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2024; 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.