Goretha Johnson

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

12960 San Pablo Ave
Richmond, CA 94805-1307

Phone

(510) 215-2280

Fax

(510) 215-2283

NPI assigned

Apr 24, 2015

Last updated

Apr 24, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Ms. Goretha Johnson Other name

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.

• Ujima Family Recovery Services

  dba Ujima West Outpatient Treatment Program

  • Substance Abuse Rehabilitation Facility
  • Richmond, CA
  • NPI 1881002541
  NPD (past)
• Ujma Family Recovery Services

  • Community/Behavioral Health Agency
  • Richmond, CA
  • NPI 1134240781
  NPD (past)

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

{
    "created_epoch": "1429833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429833600000",
    "number": "1700273950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 LEKE WAY",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "948061753",
            "telephone_number": "510-210-8285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12960 SAN PABLO AVE",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "948051307",
            "telephone_number": "510-215-2280",
            "fax_number": "510-215-2283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "GORETHA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-24",
        "last_updated": "2015-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GORETHA",
            "last_name": "JOHNSON",
            "prefix": "MS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jeanine Therese Joe
• Raegan Joern
• Allison Arnold Johnson, OT
• Azalia Renee Johnson
• Christopher Lee Johnson, LCSW
• Kis'Sarria Eilisha Cordia Johnson
• Naomi Johnson, LCSW
• Nathan Douglass Johnson
• Rachelle R. Johnson, N.D.
• Sheri R. Johnson

• Addiction (Substance Use Disorder) Counselor in Richmond, CA
• Providers in Richmond, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2015; 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.