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
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043263452 NPPES
California MEDICAID 1629293956
California MEDICAID 1992838437

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