Nicole Shanae Johnson, LVN

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

701991 Issued in CA

Practice address

206 Bennett Hill Dr Apt B
Vacaville, CA 95688-2942

Phone

(707) 761-0501

NPI assigned

Jun 11, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1623369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626048000000",
    "number": "1285202739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 BENNETT HILL DR APT B",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956882942",
            "telephone_number": "707-761-0501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 BENNETT HILL DR APT B",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956882942",
            "telephone_number": "707-761-0501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "NICOLE",
        "middle_name": "SHANAE",
        "name_prefix": "Ms.",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-11",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "701991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John B. Crawford DDS Inc.
• Cyril John, LCSW
• August Jamari Johnson
• Ernest Leif Johnson
• Katrina Llanillo Johnson, BCBA
• Randy Lee Johnson, DMD
• Raven Johnson
• Roy W. Johnson, PHD
• Towanda Jones-Collins
• Nanelle Lavinia Jones-Sullivan, M.D.

• Licensed Vocational Nurse in Vacaville, CA
• Providers in Vacaville, CA by specialty
• Licensed Vocational Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2021; 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.