Individual
HELEN VERNETTA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
987 PARALLEL DR, SUITE 104, LAKEPORT, CA 95453-5702
(707) 263-7428
(707) 263-7425
Mailing address
987 PARALLEL DR, SUITE 104, LAKEPORT, CA 95453-5702
(707) 263-7428
(707) 263-7425
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
G82139
CA
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
G82139
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G821390
—
CA
01
—
G82139
LICENSE
CA
Enumeration date
12/07/2006
Last updated
12/10/2013
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