MEDICARE: CHRISTINA CHAVEZ-JOHNSON MD, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	363LF0000X	Family Nurse Practitioner
2	363L00000X	Nurse Practitioner
3	363A00000X	Physician Assistant
4	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1336955699
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRISTINA CHAVEZ-JOHNSON MD, INC

Provider Business Mailing Address
First Line	:	10 CROW CANYON CT STE 210
Second Line	:
City	:	SAN RAMON
State	:	CA
Zip	:	94583-1980
Country	:	US
Telephone Number	:	925-519-2688
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 CROW CANYON CT STE 210
Second Line	:
City	:	SAN RAMON
State	:	CA
Zip	:	94583-1980
Country	:	US
Telephone Number	:	925-519-2688
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. FREDERICK KEHRET
Credential	:
Telephone Number	:	925-519-2688

Provider Enumeration Date	:	12/10/2024
Last Update Date	:	12/09/2025

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Directions to “CHRISTINA CHAVEZ-JOHNSON MD, INC ” Practice Location

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