James Johnson, SUDRC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

12494 Issued in CA

Practice address

107 Jackson St
Hayward, CA 94544-1948

Phone

(510) 886-8696

NPI assigned

Jul 15, 2022

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

Practice roles

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.

• Second Chance Hayward Recovery Center

  • Community/Behavioral Health Agency
  • Hayward, CA
  • NPI 1356543011
  NPD (past)

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

{
    "created_epoch": "1657843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657843200000",
    "number": "1922732767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 SHORELINE DR UNIT 2631",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945015050",
            "telephone_number": "510-692-6904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 JACKSON ST",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945441948",
            "telephone_number": "510-886-8696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JAMES",
        "credential": "SUDRC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-15",
        "last_updated": "2022-07-15",
        "certification_date": "2022-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "12494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher David Johnson, M.D.
• De'Andra O Johnson
• Eric Johnson II
• Erica Michelle Guajardo Johnson, BIRTH DOULA
• Jacqueline Johnson
• Jessica Leigh Johnson, LCSW
• Julian Johnson
• Knute Ayhens Johnson, M.A.
• Lashae Johnson
• Marshi Nichole Johnson

• Addiction (Substance Use Disorder) Counselor in Hayward, CA
• Providers in Hayward, 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 Jul 15, 2022; 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.