Cornell Johnson Jr.
Case Manager/Care Coordinator in Fairfield, CA. Individual provider (NPI-1).
NPI number1124861620
StatusActive
Last updated in NPPESJun 13, 2024
Details
- NPI
- 1124861620
- Entity type
- Individual (NPI-1)
- Name
- Cornell Johnson Jr.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 13, 2024
- Certification date
- Jun 13, 2024
- Last updated
- Jun 13, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171M00000X | Case Manager/Care Coordinator | – | – | Yes |
Practice location
3700 Hilborn Rd Ste 950Fairfield, CA 94534-7999
Phone 707-639-1138
Mailing address
3700 Hilborn Rd Ste 950Fairfield, CA 94534-7999
Phone 707-639-1138
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 63 Case Manager/Care Coordinator providers in Fairfield · All 4,218 providers in Fairfield
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