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General NPI Number Information
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NPI Number | 1326962739
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Entity Type | Individual
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Provider Name | LYNELLE RAE JOHNSON DVM, PHD
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Gender | Female
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Dates
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Enumeration Date | 08/07/2026
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Last Update Date | 08/07/2026
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Provider Practice Location Address
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Address Line | ONE GARROD DRIVE
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City | DAVIS
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State | CA
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Zip | 95616-2713
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Country | US
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Telephone | 530-752-1393
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Fax |
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Provider Business Mailing Address
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Address Line | 3206 CUTTER PL
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City | DAVIS
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State | CA
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Zip | 95616-2713
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number | 27118
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License Number State | CA
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