Johnson, Wanda Harriette
Johnson, Wanda Harriette is an individual health care provider with primary practice located at 10700 Macarthur Blvd East Oakland Clinic, Suite 14B, Oakland CA 94605-5260. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Johnson, Wanda Harriette can be contacted via phone (510) 563-4300.Contact Information
Primary practice address
10700 Macarthur Blvd East Oakland Clinic, Suite 14B
Oakland CA 94605-5260
Phone: (510) 563-4300
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 13709 | California |
Profile Details
| NPI number | 1043263452 |
|---|---|
| LBN Legal business name | Johnson, Wanda Harriette |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 18th, 2006 |
| Last updated | Oct 26th, 2012 - about 12 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 | 1043263452 | NPPES |
| California | MEDICAID | 1629293956 | |
| California | MEDICAID | 1992838437 |
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