Provider Demographics
NPI:1912120890
Name:JOHNSON, BARBARA J (RN)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:J
Last Name:JOHNSON
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 1:9567 E HEANEY CIR
Mailing Address - Street 2:
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92071-2928
Mailing Address - Country:US
Mailing Address - Phone:858-495-5912
Mailing Address - Fax:
Practice Address - Street 1:9335 HAZARD WAY
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1222
Practice Address - Country:US
Practice Address - Phone:858-495-5912
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN457676163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health