Nicole Marie Johnson, OTR/L

Primary specialty

Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X

License

23462 Issued in CA

Practice address

7676 Hazard Center Dr Ste 500
San Diego, CA 92108-4508

Phone

(800) 585-1299

NPI assigned

May 24, 2023

Sex

Female

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)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1684886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1669164992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "579 RIVERSIDE PARK RD",
            "city": "CARLOTTA",
            "state": "CA",
            "postal_code": "955289644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7676 HAZARD CENTER DR STE 500",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084508",
            "telephone_number": "800-585-1299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-24",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "CA",
            "license": "23462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathan D Johnson, O.D.
• Nicole Johnson, PA-C, MPH
• Nicole Johnson
• Nicole Elizabeth Johnson, CADTP #6406
• Nicole Louise Johnson, LCSW
• Nicole Nonsha Johnson
• Nicole S. Johnson
• Patricia Ann Johnson, RRW
• Patricia Ann Johnson, NP
• Patricia M Johnson, NP

• Physical Rehabilitation Occupational Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Physical Rehabilitation Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; 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.