Individual provider Active NPI

Nellie Preble Johnson, RN

  • Registered Nurse
  • Redondo Beach, CA
National Provider Identifier
1043167331
Registry record updated Mar 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
643918 Issued in CA
Practice address
260 Via Linda Vis
Redondo Beach, CA 90277-6408
Phone
(213) 519-4006
NPI assigned
Mar 14, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 643918 CA Primary

Addresses

Primary practice location

260 Via Linda Vis
Redondo Beach, CA 90277-6408

Mailing address

260 Via Linda Vis
Redondo Beach, CA 90277-6408
Phone (213) 519-4006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
643918CAMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1773446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773446400000",
    "number": "1043167331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 VIA LINDA VIS",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902776408",
            "telephone_number": "213-519-4006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 VIA LINDA VIS",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902776408",
            "telephone_number": "213-519-4006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "NELLIE",
        "middle_name": "PREBLE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-03-14",
        "last_updated": "2026-03-14",
        "certification_date": "2026-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "643918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redondo Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.