Individual provider Active NPI

Tulani Ain Johnson, PA-C

  • Physician Assistant
  • San Diego, CA
National Provider Identifier
1508049719
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA54077 Issued in CA
Practice address
1111 6TH Ave Ste 521
San Diego, CA 92101-5209
Phone
(833) 246-6363
NPI assigned
Dec 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA54077 CA Primary

Addresses

Primary practice location

1111 6TH Ave Ste 521
San Diego, CA 92101-5209

Mailing address

15411 Swan Creek Dr
Houston, TX 77095-2017
Phone (833) 246-6363

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA54077CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carbon Health Primary Care of California PC PastSince Jul 20, 2025 Accepting new patients
Dennis James Bonner, MD, LTD Physician Assistant Past Accepting new patients
Premier Immediate Medical Care, LLC Past Accepting new patients
Dennis James Bonner, M.D., LTD PastSince Mar 13, 1998 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: tulani.johnson.p1@direct.cdsdp.nextgenshare.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1508049719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15411 SWAN CREEK DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770952017",
            "telephone_number": "833-246-6363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 6TH AVE STE 521",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921015209",
            "telephone_number": "833-246-6363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TULANI",
        "middle_name": "AIN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-11",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA54077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2025; 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.