Active NPI
Brenda L Johnson, RPH
- Pharmacist
- Roseville, CA
National Provider Identifier
1457652794
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 54243
- Practice address
- 989 Sunrise Ave
Roseville, CA 95661-4506 - Phone
- (916) 773-4115
- Fax
- (916) 773-4173
- NPI assigned
- Nov 3, 2010
- Last updated
- Nov 3, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 54243 | CA | Primary |
Addresses
Primary practice location
989 Sunrise Ave
Roseville, CA 95661-4506
Mailing address
989 Sunrise Ave
Roseville, CA 95661-4506
Phone (916) 773-4115
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 54243 | CA | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Safeway Inc | Past | Accepting new patients | |
| Safeway Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288742400000",
"number": "1457652794",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "989 SUNRISE AVE",
"city": "ROSEVILLE",
"state": "CA",
"postal_code": "956614506",
"telephone_number": "916-773-4115",
"fax_number": "916-773-4173"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "989 SUNRISE AVE",
"city": "ROSEVILLE",
"state": "CA",
"postal_code": "956614506",
"telephone_number": "916-773-4115",
"fax_number": "916-773-4173"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "BRENDA",
"middle_name": "L",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-11-03",
"last_updated": "2010-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "54243",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roseville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.