Organization Active NPI

Stephane E. Johnson, MD, P.C.

  • Psychiatry Physician
  • Murrieta, CA
National Provider Identifier
1912364175
Registry record updated Jan 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A100636 Issued in CA
Legal business name
STEPHANE E. JOHNSON, MD, P.C.
Practice address
28078 Baxter Rd
Suite 228
Murrieta, CA 92563-1402
Phone
(951) 387-2676
Fax
(888) 882-0485
NPI assigned
Jan 19, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2016

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

Authorized official

Name
Stephane E. Johnson, M.D.
Title
Psychiatrist
Phone
(951) 387-2676

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X A100636 CA Primary

Addresses

Primary practice location

28078 Baxter Rd
Suite 228
Murrieta, CA 92563-1402

Mailing address

41593 Winchester Rd
Suite 200
Temecula, CA 92590-4860
Phone (951) 387-2676

Other identifiers 1

IdentifierTypeStateIssuer
A100636OtherCASTATE MEDICAL LICENSE

National Provider Directory

National Provider Directory

Locations

28078 Baxter Rd
Ste 228
Murrieta, CA 92563
Phone (909) 521-8698

NPI Registry JSON

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

{
    "created_epoch": "1453161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453161600000",
    "number": "1912364175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41593 WINCHESTER RD",
            "address_2": "SUITE 200",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925904860",
            "telephone_number": "951-387-2676",
            "fax_number": "888-882-0485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28078 BAXTER RD",
            "address_2": "SUITE 228",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925631402",
            "telephone_number": "951-387-2676",
            "fax_number": "888-882-0485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHANE E. JOHNSON, MD, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-19",
        "last_updated": "2016-01-19",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "STEPHANE",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PSYCHIATRIST",
        "authorized_official_telephone_number": "951-387-2676",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A100636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "A100636",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrieta, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2016; 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.