Individual
CAROL M JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
751 S BASCOM AVE, NEONATOLOGY, SAN JOSE, CA 95128-2604
(408) 885-5420
Mailing address
751 S BASCOM AVE, SAN JOSE, CA 95128-2604
(408) 885-5000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN543317
CA
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
RN543317
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RN543317
—
CA
Enumeration date
12/12/2006
Last updated
09/13/2007
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