Bennadine Johnson, PSYCHOLOGICAL ASSIST

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSB94022308 Issued in CA

Practice address

1501 5TH Ave Ste 100
San Diego, CA 92101-3251

Phone

(619) 461-3717

Fax

(619) 456-0832

NPI assigned

Mar 16, 2016

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

State licenses

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

{
    "created_epoch": "1458086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458086400000",
    "number": "1679934822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 5TH AVE STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921013251",
            "telephone_number": "619-461-3717",
            "fax_number": "619-456-0832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 5TH AVE STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921013251",
            "telephone_number": "619-461-3717",
            "fax_number": "619-456-0832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BENNADINE",
        "credential": "PSYCHOLOGICAL ASSIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-16",
        "last_updated": "2016-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSB94022308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Autumn C Johnson, LCSW
• Autumn Marie Johnson, PA-C
• Barbara J Johnson, RN
• Barry Johnson
• Benjamin Franklin Johnson, M.D.
• Beth Hagerty Johnson, M.D.
• Blanca Johnson
• Bob J Johnson, DC
• Brandon Johnson
• Brett Johnson, MD

• Psychologist in San Diego, CA
• Providers in San Diego, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2016; 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.