Provider Demographics
NPI:1811328354
Name:JOHNSON, RACHEAN LYNNETTE
Entity type:Individual
Prefix:MS
First Name:RACHEAN
Middle Name:LYNNETTE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:972 MISSION ST FL 3
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-2992
Mailing Address - Country:US
Mailing Address - Phone:415-487-3300
Mailing Address - Fax:844-364-0133
Practice Address - Street 1:972 MISSION ST FL 3
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2992
Practice Address - Country:US
Practice Address - Phone:415-487-3300
Practice Address - Fax:844-364-0133
Is Sole Proprietor?:No
Enumeration Date:2013-12-10
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist