Individual
MS. VIDAH JOHNSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
510 17TH ST, OAKLAND, CA 94612-1553
(510) 318-7119
Mailing address
513 FRUMENTI COURT, MARTINEZ, CA 94553
(925) 699-6564
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
708803
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
708803
RN LICENSE
CA
Enumeration date
07/22/2014
Last updated
07/22/2014
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