Provider Demographics
NPI:1093290520
Name:JOHNSON, KARLEE BARNES (PA-C)
Entity Type:Individual
Prefix:
First Name:KARLEE
Middle Name:BARNES
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1199 BUSH ST STE 500
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-5976
Mailing Address - Country:US
Mailing Address - Phone:156-742-6004
Mailing Address - Fax:415-674-2601
Practice Address - Street 1:1199 BUSH ST STE 500
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-5976
Practice Address - Country:US
Practice Address - Phone:415-674-2600
Practice Address - Fax:415-674-2601
Is Sole Proprietor?:No
Enumeration Date:2018-10-01
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA56632207R00000X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1093290520OtherINTERNAL