Provider Demographics
NPI:1013141159
Name:JOHNSTON, BEVERLY JOAN (RN)
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:JOAN
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18432 GRIDLEY ROAD
Mailing Address - Street 2:
Mailing Address - City:ARTESIA
Mailing Address - State:CA
Mailing Address - Zip Code:90701-5404
Mailing Address - Country:US
Mailing Address - Phone:562-860-2479
Mailing Address - Fax:562-860-7109
Practice Address - Street 1:18432 GRIDLEY RD
Practice Address - Street 2:
Practice Address - City:ARTESIA
Practice Address - State:CA
Practice Address - Zip Code:90701-5404
Practice Address - Country:US
Practice Address - Phone:562-860-2479
Practice Address - Fax:562-860-7109
Is Sole Proprietor?:No
Enumeration Date:2009-05-04
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA361862163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health