Susannah Johnson, NUTRITIONIST

Primary specialty

NutritionistTaxonomy code 133N00000X

Practice address

539 San Bernardino Ave
Newport Beach, CA 92663-4812

Phone

(650) 464-8659

NPI assigned

Mar 7, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1583539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583539200000",
    "number": "1588299853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "539 SAN BERNARDINO AVE",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926634812",
            "telephone_number": "650-464-8659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "539 SAN BERNARDINO AVE",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926634812",
            "telephone_number": "650-464-8659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SUSANNAH",
        "credential": "NUTRITIONIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-07",
        "last_updated": "2020-03-07",
        "certification_date": "2020-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Michael Johnson, D.D.S.
• Sara Johnson, L.M.T.
• Sheralyn Johnson, PT, DPT
• Stephen Herbert Johnson, M.D.
• Summer Johnson
• Darcey Lee Johnston, PSY.D
• Jon Erik Glenn DDS a Professional Corporation
• Jon M. Grazer MD MPH Inc
• Jona LLC, Dba Newport Medical Supply
• Jonathan H. Wheeler M.D., Inc.

• Nutritionist in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Nutritionist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2020; 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.