Individual
MS. INDRA JOHANSSON-MATTHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
401 BICENTENNIAL WAY, SANTA ROSA, CA 95403-2149
(707) 571-4000
Mailing address
401 BICENTENNIAL WAY, SANTA ROSA, CA 95403-2149
(707) 571-4000
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1597
CA
367500000X
Certified Registered Nurse Anesthetist
RN366332
CA
Other
Enumeration date
12/07/2006
Last updated
07/16/2007
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