Active NPI
Julie Marie Johnson, COTA/L
- Neurorehabilitation Occupational Therapist
- Concord, CA
National Provider Identifier
1730839366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurorehabilitation Occupational Therapist
- License
- 2646
- Practice address
- 3806 Clayton Rd
Concord, CA 94521-2516 - Phone
- (925) 689-2266
- NPI assigned
- Mar 26, 2022
- 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 |
|---|---|---|---|---|
| Neurorehabilitation Occupational Therapist | 225XN1300X | 2646 | CA | Primary |
Addresses
Primary practice location
3806 Clayton Rd
Concord, CA 94521-2516
Mailing address
2555 Flosden Rd SPC 66
American Canyon, CA 94503-3922
Phone (707) 980-7321
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 91279503F4 | Other | CA | PARTNERSHIP HEALTHPLAN OF CALIFORNIA |
Other names 1
- Julie Marie Shively
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | laptops | Health Information Exchange (HIE) |
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 |
|---|---|---|---|
| 2646 | CA | MD | Neurorehabilitation Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648252800000",
"number": "1730839366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2555 FLOSDEN RD SPC 66",
"city": "AMERICAN CANYON",
"state": "CA",
"postal_code": "945033922",
"telephone_number": "707-980-7321"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3806 CLAYTON RD",
"city": "CONCORD",
"state": "CA",
"postal_code": "945212516",
"telephone_number": "925-689-2266"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "JULIE",
"middle_name": "MARIE",
"credential": "COTA/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-26",
"last_updated": "2022-03-26",
"certification_date": "2022-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "225XN1300X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Neurorehabilitation",
"state": "CA",
"license": "2646",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PARTNERSHIP HEALTHPLAN OF CALIFORNIA",
"identifier": "91279503F4",
"state": "CA"
}
],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "laptops",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Skilled Nursing Facility",
"address_1": "3806 Clayton Rd",
"city": "Concord",
"state": "CA",
"country_code": "US",
"postal_code": "945212516",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "JULIE",
"last_name": "SHIVELY",
"middle_name": "MARIE",
"credential": "COTA/L",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Concord, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.