Johnnie CHI, D.O.
Individual provider Active NPI Psychiatry Physician · Patton, CA
NPI 1629416482 · NPPES record last updated Mar 22, 2017
Key facts
- NPI
- 1629416482
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 15342 (CA)
- Practice address
- 3102 E Highland Ave
Patton, CA 92369-7813 - Phone
- (909) 425-7000
- Fax
- (909) 425-6635
- NPI assigned
- Jun 13, 2013
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15342 | CA | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 15342 | CA | Yes |
| Psychiatry Physician | 2084P0800X | DO170803 | OR |
Addresses
Primary practice location
3102 E Highland Ave
Patton, CA 92369-7813
Mailing address
3102 E Highland Ave
Patton, CA 92369-7813
Phone (909) 425-7000
Other providers in Patton, CA
- Mireille C Castan
- Wendy Chan
- Carise Elizabeth Charles
- Elsie Cheng
- Rosemary Santos Chequer
- Yok H Choi
- Beth Lily Chung
- Sang Van Chung
- Kimberly Doreatha Claggett
- Michael Clarke
All providers in Patton, CA · Psychiatry Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 22, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.