MEDICARE: DR. KIMBERLY JOHNSON DC

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	111N00000X	Chiropractor	32771	CA

General Provider Information

NPI Number	:	1801399928
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIMBERLY JOHNSON DC

Provider Business Mailing Address
First Line	:	2419 HARBOR BLVD STE 134
Second Line	:
City	:	VENTURA
State	:	CA
Zip	:	93001-3904
Country	:	US
Telephone Number	:	805-901-9394
Fax Number	:

Provider Business Practice Location Address
First Line	:	487 N TURNPIKE RD
Second Line	:
City	:	SANTA BARBARA
State	:	CA
Zip	:	93111-1955
Country	:	US
Telephone Number	:	805-901-9394
Fax Number	:

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

Provider Enumeration Date	:	03/15/2018
Last Update Date	:	03/17/2018

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