Johnson, Tracey J

Johnson, Tracey J is an individual health care provider with primary practice located at 3 Medical Plaza Dr #260, Roseville CA 95661-3087. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Johnson, Tracey J can be contacted via phone (916) 773-7977.

Contact Information

Primary practice address
3 Medical Plaza Dr #260 Roseville CA 95661-3087
Phone: (916) 773-7977
Fax: (916) 773-7979
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X NP6930 California

Profile Details

NPI number 1053410571
LBN Legal business name Johnson, Tracey J
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 21st, 2006
Last updated Oct 25th, 2013 - about 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053410571 NPPES
California MEDICAID RN358159

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