Individual provider Active NPI

Monique Johnson

  • Licensed Practical Nurse
  • Sacramento, CA
National Provider Identifier
1407306319
Registry record updated Oct 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN5151324 Issued in FL
Practice address
539 Aviator Cir
Sacramento, CA 95835-1255
Phone
(916) 806-7512
NPI assigned
Oct 4, 2016
Last updated
Oct 4, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X PN5152346 FL
Nurse's Aide 376K00000X FL
Licensed Practical Nurse 164W00000X PN5151324 FL Primary

Addresses

Primary practice location

539 Aviator Cir
Sacramento, CA 95835-1255

Mailing address

539 Aviator Cir
Sacramento, CA 95835-1255
Phone (916) 806-7512

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

State licenses

LicenseStateTypeSpecialty
PN5152346FLMDMental Health Counselor
PN5151324FLMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1475539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475539200000",
    "number": "1407306319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "539 AVIATOR CIR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958351255",
            "telephone_number": "916-806-7512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "539 AVIATOR CIR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958351255",
            "telephone_number": "916-806-7512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MONIQUE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-04",
        "last_updated": "2016-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "PN5152346",
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "FL",
            "license": "PN5151324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2016; 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.