Tracey J Johnson, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

NP6930 Issued in CA

Practice address

3 Medical Plaza Dr
#260
Roseville, CA 95661-3087

Phone

(916) 773-7977

Fax

(916) 773-7979

NPI assigned

Sep 21, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382659200000",
    "number": "1053410571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10470 OLD PLACERVILLE RD",
            "address_2": "SUITE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272539",
            "telephone_number": "800-470-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 MEDICAL PLAZA DR",
            "address_2": "#260",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613087",
            "telephone_number": "916-773-7977",
            "fax_number": "916-773-7979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TRACEY",
        "middle_name": "J",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2013-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP6930",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RN358159",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melanie Johnson, M.S.
• Melissa Ann Johnson, M.D.
• Rebecca Johnson, M.S.
• Samuel Elan Johnson, D.O.
• Scott S. Johnson, MD
• Alyssa Virginia Johnston, NP
• Jon James Johnston, D.O
• Kent W. Jolly, MD
• Jon Perlstein, M.D., Inc
• Yesenia Jonach Mendez, M.S CCC-SLP

• Nurse Practitioner in Roseville, CA
• Providers in Roseville, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2013; 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.