Individual provider Active NPI

Chrisanna Johnson, M.D.

  • Family Medicine Physician
  • Oceanside, CA
National Provider Identifier
1396723169
Registry record updated Mar 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A82011 Issued in CA
Practice address
3609 Ocean Ranch Blvd
Ste 110
Oceanside, CA 92056-2698
Phone
(760) 754-0974
Fax
(760) 725-1232
NPI assigned
Jan 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A82011 CA Primary

Addresses

Primary practice location

3609 Ocean Ranch Blvd
Ste 110
Oceanside, CA 92056-2698

Mailing address

3609 Ocean Ranch Blvd
Ste 110
Oceanside, CA 92056-2698
Phone (760) 754-0974

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A82011CAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363824000000",
    "number": "1396723169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3609 OCEAN RANCH BLVD",
            "address_2": "STE 110",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920562698",
            "telephone_number": "760-754-0974",
            "fax_number": "760-725-1232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3609 OCEAN RANCH BLVD",
            "address_2": "STE 110",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920562698",
            "telephone_number": "760-754-0974",
            "fax_number": "760-725-1232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CHRISANNA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-03",
        "last_updated": "2013-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A82011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

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