Stephane E Johnson, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A100636 Issued in CA

Practice address

41593 Winchester Rd
Suite 200
Temecula, CA 92590-4860

Phone

(951) 387-2676

Fax

(888) 882-0485

NPI assigned

Feb 15, 2008

Sex

Male

Sole proprietor

Yes

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Department of State Hospitals

  • Psychiatric Hospital
  • Coalinga, CA
  • NPI 1124078704
  Medicare reassignment NPD
• Department of State Hospitals

  • Psychiatric Hospital
  • Patton, CA
  • NPI 1043249204
  NPD
• Department of State Hospitals

  • Psychiatric Hospital
  • Atascadero, CA
  • NPI 1174573802
  NPD

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

{
    "created_epoch": "1203033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452124800000",
    "number": "1942478607",
    "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": "41593 WINCHESTER RD",
            "address_2": "SUITE 200",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925904860",
            "telephone_number": "951-387-2676",
            "fax_number": "888-882-0485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "STEPHANE",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-15",
        "last_updated": "2016-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A100636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marjan Koosha Johnson
• Matthew Johnson
• Melenie Ethel Johnson, LVN
• Monica Jean Johnson
• Ryan Johnson
• Sylvia Ann Johnson, M.D.
• Taylor D Johnson, AMFT
• Rebecca Johnston, OTD, OTR/L
• Sean Austin Johnston, DPT
• Tiffany Johnston

• Psychiatry Physician in Temecula, CA
• Providers in Temecula, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.