Individual provider Active NPI

Cecilia Johnson, CRNA

  • Certified Registered Nurse Anesthetist
  • Van Nuys, CA
National Provider Identifier
1194011189
Registry record updated Jan 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4432 Issued in CA
Practice address
15107 Vanowen St
Van Nuys, CA 91405-4542
Phone
(818) 782-6600
NPI assigned
Jun 28, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 4432 CA Primary
Registered Nurse 163W00000X 849770 CA

Addresses

Primary practice location

15107 Vanowen St
Van Nuys, CA 91405-4542

Mailing address

525 N Crescent Heights Blvd
Los Angeles, CA 90048-2207

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250409001609 NV Practitioner - Certified Registered Nurse Anesthetist (Crna) 8729240742 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
University of South Carolina School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amin Dunckelmeyer and Luu PLLCGroup PAC ID 4385002682, 48 clinicians
Red Rock Anesthesia Consultants LLCGroup PAC ID 4284910290, 109 clinicians

Practice addresses (Care Compare)

Las Vegas, NV 89117
Phone (469) 983-0099

5400 S Rainbow Blvd
Las Vegas, NV 89118-1859
Phone (702) 325-4651

Hospital & facility affiliations

  • Desert View Hospital Hospital, Pahrump, NV, CCN 291311
  • Centennial Hills Hospital Medical Center Hospital, Las Vegas, NV, CCN 290054

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
849770CAMDRegistered Nurse
4432CAMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Red Rock Anesthesia Consultants LLC CurrentSince Mar 1, 2025 Accepting new patients
Amin, Dunckelmeyer and Luu PLLC CurrentSince Mar 1, 2025 Accepting new patients
Ambulatory Care Anesthesia, PC Nurse Anesthetist, Certified Registered Past Accepting new patients
Beach Anesthesia, LLC Past Accepting new patients

Locations

5400 S Rainbow Blvd
Las Vegas, NV 89118
Phone (702) 252-7342

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1309219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485216000000",
    "number": "1194011189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 N CRESCENT HEIGHTS BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900482207",
            "fax_number": "866-519-5262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15107 VANOWEN ST",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914054542",
            "telephone_number": "818-782-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CECILIA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-28",
        "last_updated": "2017-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "4432",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "849770",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.