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General NPI Number Information
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NPI Number | 1619462371
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Entity Type | Individual
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Provider Name | SEPTEMBER ROSE JOHNSON
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Gender | Female
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Dates
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Enumeration Date | 06/26/2018
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Last Update Date | 06/26/2018
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Provider Practice Location Address
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Address Line | 5857 OWENS AVE STE 300
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City | CARLSBAD
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State | CA
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Zip | 92008-5507
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Country | US
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Telephone | 714-658-5926
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Fax |
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Provider Business Mailing Address
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Address Line | 3626 COLLEGE BLVD APT 25
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City | OCEANSIDE
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State | CA
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Zip | 92056-4641
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Country | US
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Telephone | 714-658-5926
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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 | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number |
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License Number State |
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