Trevor Russell Johnson, OTC

Primary specialty

Surgical AssistantTaxonomy code 246ZC0007X

License

OTC 09-0802

Practice address

320 Santa Fe Dr Ste 301
Encinitas, CA 92024-5140

Phone

(760) 633-4700

Fax

(760) 635-4344

NPI assigned

Oct 26, 2009

Sex

Male

Sole proprietor

No

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

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

{
    "created_epoch": "1256515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256515200000",
    "number": "1609102698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6619 BELL BLUFF AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921191148",
            "telephone_number": "619-746-9194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 SANTA FE DR STE 301",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920245140",
            "telephone_number": "760-633-4700",
            "fax_number": "760-635-4344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TREVOR",
        "middle_name": "RUSSELL",
        "name_prefix": "Mr.",
        "credential": "OTC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-26",
        "last_updated": "2009-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": null,
            "license": "OTC 09-0802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Briah Johnson
• Deanne Emilie Johnson, L.E.P., L.P.C.C., PH
• Hannah Litton Johnson, AUD
• Mitchell David Johnson, PA-C
• Robyn Denton Johnson, LCSW
• Eric William Johnston, MD
• Heather Marie Johnston, RN
• Jon G Pace, M.D., Apc
• Christina Jones Stewart, CMT
• Aaron C Jones, AU.D.

• Surgical Assistant in Encinitas, CA
• Providers in Encinitas, CA by specialty
• Surgical Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2009; 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.