Active NPI
Nan Louise Johnson, LCSW
- Mental Health Counselor
- Sacramento, CA
National Provider Identifier
1689725327
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LSW5234
- Practice address
- 6600 Bruceville Rd
Sacramento, CA 95823-4671 - Phone
- (916) 688-6635
- Fax
- (916) 688-6264
- NPI assigned
- Jan 16, 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LSW5234 | CA | Primary |
Addresses
Primary practice location
6600 Bruceville Rd
Sacramento, CA 95823-4671
Mailing address
6600 Bruceville Rd
Sacramento, CA 95823-4671
Phone (916) 688-6635
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LSW5234 | Other | CA | CONSUMER AFFAIRS, STATE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LSW5234 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1689725327",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6600 BRUCEVILLE RD",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958234671",
"telephone_number": "916-688-6635",
"fax_number": "916-688-6264"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6600 BRUCEVILLE RD",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958234671",
"telephone_number": "916-688-6635",
"fax_number": "916-688-6264"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "NAN",
"middle_name": "LOUISE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "LSW5234",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CONSUMER AFFAIRS, STATE",
"identifier": "LSW5234",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
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.