Kristin Elise Johnson, MSN, RNCS

Primary specialty

Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X

License

209713 AND 74 Issued in CA

Practice address

2377 Gold Meadow Way
Suite 100
Gold River, CA 95670-4405

Phone

(916) 213-6766

NPI assigned

Jan 15, 2007

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

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Certified Nurse Specialist, Master of Science - Nursing

State licenses

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273449600000",
    "number": "1437200540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11367 HUNTINGTON VILLAGE LN",
            "city": "GOLD RIVER",
            "state": "CA",
            "postal_code": "956707523",
            "telephone_number": "916-213-6766",
            "fax_number": "916-859-0677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2377 GOLD MEADOW WAY",
            "address_2": "SUITE 100",
            "city": "GOLD RIVER",
            "state": "CA",
            "postal_code": "956704405",
            "telephone_number": "916-213-6766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KRISTIN",
        "middle_name": "ELISE",
        "name_prefix": "Ms.",
        "credential": "MSN, RNCS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-15",
        "last_updated": "2010-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "CA",
            "license": "209713 AND 74",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Intellimed Health
• Katie Anne Jackson, M.A. CCC-SLP/BCBA
• Jade Marriage and Family Therapy, Inc.
• Sarah Marie Jantz
• Rachana Jivan, PHARM D
• Jose V. Juarez, D.D.S. Inc.
• James Robert Joyce, D.D.S.
• Jose Vicente Juarez, D.D.S.
• Joseph Thomas Kadic, PHARMACIST
• Lori Dianne Kam, O.D.

• All providers in Gold River, CA
• Adult Psychiatric/Mental Health Clinical Nurse Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2010; 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.