Provider Demographics
NPI:1356478069
Name:JOHNSTON, ROBERT BRIAN (CAS, NCAC)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:BRIAN
Last Name:JOHNSTON
Suffix:
Gender:M
Credentials:CAS, NCAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 HOWE AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-4731
Mailing Address - Country:US
Mailing Address - Phone:916-993-4131
Mailing Address - Fax:916-993-4886
Practice Address - Street 1:650 HOWEN AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-1412
Practice Address - Country:US
Practice Address - Phone:916-993-4131
Practice Address - Fax:916-993-4886
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA171M00000XOtherMHA III