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General NPI Number Information
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NPI Number | 1932425956
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Entity Type | Individual
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Provider Name | ALEXANDRA ROTHENBERG JOHNSON MD
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Gender | Female
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Dates
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Enumeration Date | 04/15/2010
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Last Update Date | 12/27/2023
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Provider Practice Location Address
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Address Line | 1690 GLEN CANYON RD
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City | SANTA CRUZ
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State | CA
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Zip | 95060-1219
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Country | US
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Telephone | 510-455-8008
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Fax | 510-244-0569
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Provider Business Mailing Address
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Address Line | 1690 GLEN CANYON RD
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City | SANTA CRUZ
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State | CA
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Zip | 95060-1219
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Country | US
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Telephone | 510-455-8008
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Fax | 510-244-0569
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A148633
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License Number State | CA
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