MEDICARE: EARL JAMES YBANEZ JOHNS NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	95035796	CA
2	163WP0807X	Child & Adolescent Psychiatric/Mental Health Registered Nurse	95223998	CA

General Provider Information

NPI Number	:	1033901574
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EARL JAMES YBANEZ JOHNS NP

Provider Business Mailing Address
First Line	:	490 POST ST STE 939
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94102-1414
Country	:	US
Telephone Number	:	415-409-9286
Fax Number	:	415-449-3482

Provider Business Practice Location Address
First Line	:	555 MINNA ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94103-2831
Country	:	US
Telephone Number	:	415-697-0490
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2025
Last Update Date	:	12/03/2025

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