Robert Gary Johannsen
Individual provider Active NPI Peer Specialist · Lake Isabella, CA
NPI 1134099088 · NPPES record last updated Nov 6, 2025
Key facts
- NPI
- 1134099088
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Peer Specialist 175T00000X
- License
- MPSS-EKZJXM (CA)
- Practice address
- 2731 Nugget Ave
Lake Isabella, CA 93240-9456 - Phone
- (760) 379-3412
- Fax
- (760) 379-5332
- NPI assigned
- Nov 6, 2025
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MPSS-EKZJXM | CA | MD | Peer Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | MPSS-EKZJXM | CA | Yes |
Addresses
Primary practice location
2731 Nugget Ave
Lake Isabella, CA 93240-9456
Mailing address
2731 Nugget Ave
Lake Isabella, CA 93240-9456
Phone (760) 379-3412
Other providers in Lake Isabella, CA
- Ikenna Chinaka Ikeri
- Isabella Emergency Physicians
- Kristy Dawn Jackson
- Jaime S. Lee Ho MD Inc.
- Cindy B Jewett
- Patricia Ann Jones
- Joseph M Kent DDS Inc.
- James E Kent
- Joseph Maughan Kent
- Kern River Valley Care Center
All providers in Lake Isabella, CA · Peer Specialist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 6, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.