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Individual

MS. KATHRYN JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN,NP

Contact information

Practice address
412 CEDAR ST, SUITE C, SANTA CRUZ, CA 95060-4369
(831) 425-3337
(831) 466-0366
Mailing address
106 FAIRVIEW AVE, CAPITOLA, CA 95010-3427
(831) 475-3951
(831) 475-3951

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
509229
CA
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
509229
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GR0050890
CA
Enumeration date
03/22/2007
Last updated
02/10/2012
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