Johnson, Danielle Rae
Johnson, Danielle Rae is an individual health care provider with primary practice located at 8220 N Cornerstone Dr Ste A , Hayden ID 83835-8683. She recently has 3 registered licenses in different health care specialties including Eye and Vision Services Providers / Pediatrics, Student, Health Care / Student in an Organized Health Care Education/Training Program, Eye and Vision Services Providers / Optometrist. Eye and Vision Services Providers / Optometrist is her primary health care specialty. Johnson, Danielle Rae can be contacted via phone (208) 772-5539.Contact Information
Primary practice address
8220 N Cornerstone Dr Ste A
Hayden ID 83835-8683
Phone: (208) 772-5539
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Pediatrics | 152WP0200X | 34593 | California |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Eye and Vision Services Providers / Optometrist | 152W00000X | ODP-100539 | Idaho |
Profile Details
| NPI number | 1023637733 |
|---|---|
| LBN Legal business name | Johnson, Danielle Rae |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 13th, 2020 |
| Last updated | Jun 7th, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1023637733 | NPPES |
| California | MEDICAID | CA430443 |
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