Active NPI
Glenn Phelps Johnson Jr.
- Rehabilitation Practitioner
- Woodland, CA
National Provider Identifier
1710249255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- Practice address
- 137 N Cottonwood St
Suite 1530
Woodland, CA 95695-6646 - Phone
- (530) 666-9546
- NPI assigned
- Jun 11, 2012
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | CA | Primary |
Addresses
Primary practice location
137 N Cottonwood St
Suite 1530
Woodland, CA 95695-6646
Mailing address
137 N Cottonwood St Ste 1530
Woodland, CA 95695-6664
Phone (530) 666-9546
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778198400000",
"number": "1710249255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "137 N COTTONWOOD ST STE 1530",
"city": "WOODLAND",
"state": "CA",
"postal_code": "956956664",
"telephone_number": "530-666-9546"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "137 N COTTONWOOD ST",
"address_2": "SUITE 1530",
"city": "WOODLAND",
"state": "CA",
"postal_code": "956956646",
"telephone_number": "530-666-9546"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "GLENN",
"middle_name": "PHELPS",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-06-11",
"last_updated": "2026-05-08",
"certification_date": "2026-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Woodland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.