Active NPI
Amanda Michelle Johnson, RN
- Psychiatric/Mental Health Nurse Practitioner
- Los Angeles, CA
National Provider Identifier
1861174476
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 95039305
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 851704 | CA | MD | Psychiatric/Mental Health Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Health & Rehabilitation Program | Past | Accepting new patients | |
| Southern California Health & Rehabilitation Program | Past | Accepting new patients |
Interoperability endpoints
- 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.
-
- Community/Behavioral Health Agency
- Los Angeles, CA
- NPI 1083743082
-
- Community/Behavioral Health Agency
- Lynwood, CA
- NPI 1467775221
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.