Individual provider Active NPI

Alexandria Johnson, LVN

  • Licensed Vocational Nurse
  • Lodi, CA
National Provider Identifier
1407568686
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
710544 Issued in CA
Practice address
541 S Ham LN Ste a&B
Lodi, CA 95242-3059
Phone
(209) 553-0798
NPI assigned
Dec 19, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 710544 CA Primary

Addresses

Primary practice location

541 S Ham LN Ste a&B
Lodi, CA 95242-3059

Mailing address

541 S Ham LN Ste a&B
Lodi, CA 95242-3059
Phone (209) 663-8521

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
710544CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1671408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1407568686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 S HAM LN STE A&B",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952423059",
            "telephone_number": "209-663-8521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 S HAM LN STE A&B",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952423059",
            "telephone_number": "209-553-0798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ALEXANDRIA",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-19",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "710544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lodi, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2023; 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.