NPIMap

Organization Active NPI

Debra a. Johnson, PH.D., a Psychology Corporation

  • Community/Behavioral Health Agency
  • Modesto, CA
National Provider Identifier
1760510820
Registry record updated Feb 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
DEBRA A. JOHNSON, PH.D., A PSYCHOLOGY CORPORATION
Practice address
610 14TH St
Modesto, CA 95354-2505
Phone
(209) 524-4858
Fax
(209) 524-7780
NPI assigned
Mar 1, 2007
Last updated
Feb 7, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2008

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

Authorized official

Name
Dr. Debra A Johnson, PH. D.
Title
Owner
Phone
(209) 527-4682

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

610 14TH St
Modesto, CA 95354-2505

Mailing address

615 15TH St
Modesto, CA 95354-2510
Phone (209) 527-4682

Other identifiers 1

IdentifierTypeStateIssuer
5027MedicaidCA

Other names 1

  • Child Sexual Abuse Treatment Services Other name

National Provider Directory

National Provider Directory

Locations

615 15th St
Modesto, CA 95354
Phone (209) 527-4682

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202342400000",
    "number": "1760510820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 15TH ST",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953542510",
            "telephone_number": "209-527-4682",
            "fax_number": "209-524-7780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 14TH ST",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953542505",
            "telephone_number": "209-524-4858",
            "fax_number": "209-524-7780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEBRA A. JOHNSON, PH.D., A PSYCHOLOGY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2008-02-07",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-527-4682",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH. D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5027",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Child Sexual Abuse Treatment Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2008; 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.