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NPI Code Detail

MEDICARE: ANDREA JEAN MARIE JOHNSON

MEDICARE: ANDREA JEAN MARIE JOHNSON
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1982461703
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA JEAN MARIE JOHNSON
Provider Business Mailing Address
First Line : PO BOX 1000
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93302-1000
Country : US
Telephone Number : 661-868-1840
Fax Number :
Provider Business Practice Location Address
First Line : 2525 N CHESTER AVE
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93308-1770
Country : US
Telephone Number : 661-868-1840
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2024
Last Update Date : 06/01/2026

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Directions to “ ANDREA JEAN MARIE JOHNSON ” Practice Location

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