Doctor Name: | ELAINE I JOHNSON |
NPI Number: | 1033253125 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN |
License Number: | 583767 |
Business Practice Address: | 2640 Breslauer Way Redding, CA - 960014246 |
Business Phone Number: | 5302255200 |
Business Fax Number: | |
Mailing Address: | Po Box 496048, REDDING |
State: | CA |
Postal Code: | 960496048 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 02/20/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WP0808X |
License Number: | 583767 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |