Individual provider Active NPI

Robert Matthew Johns, MA, NCSP, BCBA

  • Behavior Analyst
  • Santa Rosa, CA
National Provider Identifier
1972395259
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-22-62366
Practice address
422 Larkfield Ctr # 246
Santa Rosa, CA 95403-1408
Phone
(707) 350-2736
NPI assigned
May 21, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X 210044684 CA
Behavior Analyst 103K00000X 1-22-62366 Primary

Addresses

Primary practice location

422 Larkfield Ctr # 246
Santa Rosa, CA 95403-1408

Mailing address

422 Larkfield Ctr # 246
Santa Rosa, CA 95403-1408
Phone (707) 350-2736

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
Master of Arts

State licenses

LicenseStateTypeSpecialty
210044684CAMDSchool Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1747785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1972395259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "422 LARKFIELD CTR # 246",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954031408",
            "telephone_number": "707-350-2736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 LARKFIELD CTR # 246",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954031408",
            "telephone_number": "707-350-2736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNS",
        "first_name": "ROBERT",
        "middle_name": "MATTHEW",
        "credential": "MA, NCSP, BCBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-05-21",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "CA",
            "license": "210044684",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-22-62366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2025; 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.