Individual provider Active NPI

Laurel Johnson, RN

  • Registered Nurse
  • San Rafael, CA
National Provider Identifier
1275320590
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
95053833 Issued in CA
Practice address
3240 Kerner Blvd
San Rafael, CA 94901-4840
Phone
(415) 473-4163
NPI assigned
Apr 21, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

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 95053833 CA Primary

Addresses

Primary practice location

3240 Kerner Blvd
San Rafael, CA 94901-4840

Mailing address

236 Miller Ave Apt a
Mill Valley, CA 94941-2873
Phone (415) 516-5537

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
95053833CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1745193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1275320590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236 MILLER AVE APT A",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949412873",
            "telephone_number": "415-516-5537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3240 KERNER BLVD",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949014840",
            "telephone_number": "415-473-4163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LAUREL",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-21",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95053833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2025; 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.