Bruce Bower Johnston, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY14156 Issued in CA

Practice address

30100 Crown Valley Pkwy
Suite 17
Laguna Niguel, CA 92677-2041

Phone

(949) 224-9072

Fax

(949) 429-8723

NPI assigned

Jan 22, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1801940689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26000 AVENIDA AEROPUERTO",
            "address_2": "#216",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926754720",
            "telephone_number": "949-224-9072",
            "fax_number": "949-429-8723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30100 CROWN VALLEY PKWY",
            "address_2": "SUITE 17",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926772041",
            "telephone_number": "949-224-9072",
            "fax_number": "949-429-8723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "BRUCE",
        "middle_name": "BOWER",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY14156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Laguna Niguel, CA
• Providers in Laguna Niguel, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.