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General NPI Number Information
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NPI Number | 1811013469
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Entity Type | Individual
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Provider Name | KATHRYN JOHNSON RN,NP
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Gender | Female
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 02/10/2012
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Provider Practice Location Address
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Address Line | 412 CEDAR ST SUITE C
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City | SANTA CRUZ
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State | CA
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Zip | 95060-4369
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Country | US
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Telephone | 831-425-3337
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Fax | 831-466-0366
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Provider Business Mailing Address
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Address Line | 106 FAIRVIEW AVE
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City | CAPITOLA
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State | CA
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Zip | 95010-3427
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Country | US
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Telephone | 831-475-3951
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Fax | 831-475-3951
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 509229
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 364SP0808X
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Taxonomy Name | Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 509229
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License Number State | CA
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