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Individual
MR. STEPHEN ARCHIE JOHNSON
Active
Individual
MR. STEPHEN ARCHIE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN, NP ,PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
12229
CA
363L00000X
Nurse Practitioner
320565
CA
363LF0000X
Family Nurse Practitioner
Primary
6882
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12229
PA
CA
Enumeration date
11/16/2005
Last updated
03/07/2023
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