Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Ennis Scott Samuel Johnson

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1265138713

Ennis Scott Samuel Johnson is an Addiction (Substance Use Disorder) Counselor in San Rafael, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2023
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Practice location Address checks out

1601 2nd St
San Rafael, CA 94901-2712
Phone: (415) 526-7810
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X (CA)

Record details

NPI number1265138713
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedFebruary 6, 2023
Last updated in NPPESFebruary 6, 2023
Certification dateFebruary 6, 2023

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