Provider Demographics
NPI:1518198068
Name:BARNER, JOHNNY L
Entity Type:Individual
Prefix:MR
First Name:JOHNNY
Middle Name:L
Last Name:BARNER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3665 KEARNY VILLA ROAD, STE. 101
Mailing Address - Street 2:RADY CHILDREN'S OUTPATIENT PSYCHIATRY
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3665 KEARNY VILLA ROAD, STE. 101
Practice Address - Street 2:RADY CHILDREN'S OUTPATIENT PSYCHIATRY
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123
Practice Address - Country:US
Practice Address - Phone:858-966-7759
Practice Address - Fax:858-966-7525
Is Sole Proprietor?:No
Enumeration Date:2009-07-31
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program