Provider Demographics
NPI:1467062794
Name:JOHNSON, ERICA (RN)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:ERICA
Other - Middle Name:DAWN
Other - Last Name:KATTO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:19208 ANNALEE AVE
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90746-2616
Mailing Address - Country:US
Mailing Address - Phone:562-230-6982
Mailing Address - Fax:
Practice Address - Street 1:765 W COLLEGE ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-1181
Practice Address - Country:US
Practice Address - Phone:213-580-7200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-02
Last Update Date:2020-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95085045163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult