KERMIT JOHNSON – Psychiatry Physician, NPI 1154533230

KERMIT JOHNSON is a healthcare provider. based in Oakland, California. specializing in Psychiatry Physician. They hold a License No. G45056 (CA). The NPI Number for KERMIT JOHNSON is 1154533230

Main info

Male
46 Years Of Experience
Accepts Medicare Assignment
Name
KERMIT JOHNSON
NPI
1154533230
Phone
(510) 268-7837
Address
568 W GRAND AVE
Enumeration Date
3 May 2007
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
UNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
Secondary Phone
9256465480
Graduation Year
1980 (46 years ago)
PAC ID
5991896680
Group Practice PAC ID
8628052974
Professional Enrollment ID
I20070809000631
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for KERMIT JOHNSON

  • 568, West Grand Avenue, Uptown, Oakland, Alameda County, California, 94612, United States

    OAKLAND, CA 946121618

    Phone: (510) 268-7837

    Type: Location

  • Mission Boulevard, Mission San Jose District, Fremont, Alameda County, California, 94537, United States

    FREMONT, CA 945395831

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 94612)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8628052974View full group profile
NameSpecialtyState
Marriage And Family TherapistCA
P S Y C H I A T R YCA
P S Y C H I A T R YPA
P S Y C H I A T R YCA
Clinical Social WorkerCA
-CA
P S Y C H I A T R YCA
Clinical PsychologistCA
-CA
Nurse PractitionerCA

Reviews

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Frequently asked questions

What is the registry number for KERMIT JOHNSON?
The registry entry for KERMIT JOHNSON shows NPI 1154533230.
Is KERMIT JOHNSON currently accepting referrals based on NPI status?
Registry metadata lists KERMIT JOHNSON as active.
What type of care does KERMIT JOHNSON provide?
KERMIT JOHNSON's profile centers on Psychiatry Physician. Clinical services aligned with this taxonomy classification.
Which community is linked to KERMIT JOHNSON?
KERMIT JOHNSON shows a connection to Oakland, California in registry-derived data.
Can I export KERMIT JOHNSON's record?
You can download the official NPPES record; we summarize key fields for readability.

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