MEDICARE: KIMI JOHNSON

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1538530050
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMI JOHNSON

Provider Business Mailing Address
First Line	:	PO BOX 5186
Second Line	:
City	:	BEAR VALLEY
State	:	CA
Zip	:	95223-5186
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	325 CREEKSIDE DRIVE
Second Line	:
City	:	BEAR VALLEY
State	:	CA
Zip	:	95223-5186
Country	:	US
Telephone Number	:	209-753-2348
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/09/2015
Last Update Date	:	10/09/2015

Similar Medicare Providers

1710201751 — BV PARENTS GROUP, INC.
Practice Location Address:

325 CREEKSIDE DRIVE
BEAR VALLEY, CA
95223-5186

Practice Phone: 209-753-2348
Practice Fax: 209-753-2345

1225073588 — VALLEY ASSOCIATED UROLOGY MEDICARE GROUP INC
Practice Location Address:

200 COTTAGE AVE , STE 101
MANTECA, CA
95336-4935

Practice Phone: 209-239-2197
Practice Fax: 209-239-7672

1518209709 — ALPINE COUNTY BEAR V ALLEY
Practice Location Address:

367 CREEKSIDE DRIVE
BEAR VALLEY, CA
95223

Practice Phone: 209-253-2831
Practice Fax: 209-753-2471

1568838084 — ALPINE COUNTY BEHAVIORAL HEALTH SERVICES
Practice Location Address:

367 CREEKSIDE DR.
BEAR VALLEY, CA
95223

Practice Phone: 209-753-2831
Practice Fax: 209-753-2471

1508724337 — M A C T HEALTH BOARD, INCORPORATED
Practice Location Address:

367 CREEKSIDE DR
BEAR VALLEY, CA
95223-9455

Practice Phone: 209-674-6198
Practice Fax: 209-674-6272

1992197537 — CONNECT THE DOTS, LLC
Practice Location Address:

5186 TREOSTI PL
VALLEY SPRINGS, CA
95252-8772

Practice Phone: 209-471-7962
Practice Fax:

Directions to “ KIMI JOHNSON ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.