Active NPI
Bruce C Johnston, MD
- Psychiatry Physician
- Oakland, CA
National Provider Identifier
1780786996
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 617737
- Practice address
- 5478A College Ave
Oakland, CA 94618 - Phone
- (510) 597-1781
- Fax
- (510) 658-6011
- NPI assigned
- Sep 1, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 617737 | CA | Primary |
Addresses
Primary practice location
5478A College Ave
Oakland, CA 94618
Mailing address
5478A College Avenue
Oakland, CA 94618
Phone (510) 597-1781
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 617737 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560902400000",
"number": "1780786996",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5478A COLLEGE AVENUE",
"city": "OAKLAND",
"state": "CA",
"postal_code": "94618",
"telephone_number": "510-597-1781",
"fax_number": "510-658-6011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5478A COLLEGE AVE",
"city": "OAKLAND",
"state": "CA",
"postal_code": "94618",
"telephone_number": "510-597-1781",
"fax_number": "510-658-6011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSTON",
"first_name": "BRUCE",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-01",
"last_updated": "2019-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "617737",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.