Provider Demographics
NPI:1245782697
Name:JOHNSON, MEREDITH LEE (NP)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:LEE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:55 MANCHESTER ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-5271
Mailing Address - Country:US
Mailing Address - Phone:415-658-6791
Mailing Address - Fax:
Practice Address - Street 1:1 SANSOME ST STE 3500
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94104-4436
Practice Address - Country:US
Practice Address - Phone:604-423-4050
Practice Address - Fax:604-243-6214
Is Sole Proprietor?:No
Enumeration Date:2016-11-02
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA95002334363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily