Rodney Dwayne Johnson, CAADE 12397-R

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

190081KN Issued in CA

Practice address

4445 Burns Ave
Los Angeles, CA 90029-2702

Phone

(323) 664-8969

Fax

(323) 664-1786

NPI assigned

Nov 16, 2017

Sex

Male

Sole proprietor

No

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1510790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510790400000",
    "number": "1841703535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4445 BURNS AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900292702",
            "telephone_number": "323-664-8969",
            "fax_number": "323-664-1786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4445 BURNS AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900292702",
            "telephone_number": "323-664-8969",
            "fax_number": "323-664-1786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "RODNEY",
        "middle_name": "DWAYNE",
        "credential": "CAADE 12397-R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-16",
        "last_updated": "2017-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "190081KN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raylene Johnson
• Renae Johnson, LPCC, ATR-BC
• Rhea E Johnson, PHD LCSW
• Robert Johnson, DDS
• Robert Jeffrey Johnson, D.C.
• Roger Duncan Johnson Jr., M.D.
• Ronald Bruce Johnson, MD
• Ronald E Johnson
• Ronderick Johnson Jr., M.S.
• Ronisha Nicole Johnson

• Addiction (Substance Use Disorder) Counselor in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2017; 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.