Individual provider Active NPI

Amanda Michelle Johnson, RN

  • Psychiatric/Mental Health Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1861174476
Registry record updated Sep 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95039305 Issued in CA
Practice address
8836 S Vermont Ave
Los Angeles, CA 90044-4832
Phone
(213) 451-4370
NPI assigned
Aug 2, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 851704 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95039305 CA Primary

Addresses

Primary practice location

8836 S Vermont Ave
Los Angeles, CA 90044-4832

Mailing address

2640 Industry Way
Lynwood, CA 90262-4284
Phone (310) 627-7452

Other practice location 1

3850 Crenshaw Blvd
Los Angeles, CA 90008-1821
Phone (323) 751-3026

Other practice location 2

2640 Industry Way
Lynwood, CA 90262-4284
Phone (310) 627-7452

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
851704CAMDPsychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Health & Rehabilitation Program Past Accepting new patients
Southern California Health & Rehabilitation Program Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/scharpca/r4/

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1690934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789084800000",
    "number": "1861174476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2640 INDUSTRY WAY",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902624284",
            "telephone_number": "310-627-7452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8836 S VERMONT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900444832",
            "telephone_number": "213-451-4370"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3850 Crenshaw Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900081821",
            "country_code": "US",
            "telephone_number": "323-751-3026",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2640 Industry Way",
            "address_purpose": "LOCATION",
            "city": "Lynwood",
            "state": "CA",
            "postal_code": "902624284",
            "country_code": "US",
            "telephone_number": "310-627-7452",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "AMANDA",
        "middle_name": "MICHELLE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-02",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "851704",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95039305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2026; 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.