Healthcare Provider Details

I. General information

NPI: 1740713452
Provider Name (Legal Business Name): JAMI JOHNSON L.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2017
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 WEST COAST RD
REDWAY CA
95560
US

IV. Provider business mailing address

PO BOX 769
REDWAY CA
95560-0769
US

V. Phone/Fax

Practice location:
  • Phone: 707-923-2783
  • Fax:
Mailing address:
  • Phone: 707-923-2783
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberLM491
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: