Provider Demographics
NPI:1407734189
Name:JOHNSON, SUMMER N (RDN)
Entity type:Individual
Prefix:
First Name:SUMMER
Middle Name:N
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16611 WOODRUFF AVE APT 30
Mailing Address - Street 2:
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-4962
Mailing Address - Country:US
Mailing Address - Phone:805-298-8202
Mailing Address - Fax:
Practice Address - Street 1:16611 WOODRUFF AVE APT 30
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-4962
Practice Address - Country:US
Practice Address - Phone:805-298-8202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-22
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86156154133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered