Keena Johnson-Bolden, FNP-BC

Primary specialty

Ambulatory Women's Health Care Registered NurseTaxonomy code 163WW0101X

License

95003776 Issued in CA

Practice address

400 W 30TH St
Los Angeles, CA 90007-3320

Phone

(213) 284-3200

NPI assigned

Oct 25, 2016

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

Other names 1

• Keena Johnson Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: keena.johnsonrnp.p1@direct.plannedparenthoodla.nextgenshare.com
• Direct secure messaging: keena.johnson.p1@direct.cdsdp.nextgenshare.com

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.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment Care Compare group NPD
• Memorialcare Medical Foundation

  • Clinic/Center
  • Fountain Valley, CA
  • NPI 1205167350
  Medicare reassignment NPD
• Minuteclinic Diagnostic Medical Group of California Inc

  • Family Nurse Practitioner
  • Burbank, CA
  • NPI 1033309372
  Medicare reassignment NPD
• Minuteclinic Diagnostic Medical Group of Orange County Inc

  • Nurse Practitioner
  • Irvine, CA
  • NPI 1104013879
  Medicare reassignment NPD
• Minuteclinic Diagnostic Medical Group of San Diego Inc

  • Family Nurse Practitioner
  • El Cajon, CA
  • NPI 1568659233
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Hawthorne, CA
  • NPI 1164914115
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD

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

{
    "created_epoch": "1477353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1780136820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W 30TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900073320",
            "telephone_number": "213-284-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W 30TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900073320",
            "telephone_number": "213-284-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON-BOLDEN",
        "first_name": "KEENA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-25",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "634327",
            "primary": false
        },
        {
            "code": "163WW0101X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Women's Health Care, Ambulatory",
            "state": "CA",
            "license": "95003776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "13652 Cantara St",
            "city": "Panorama City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "914025423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KEENA",
            "last_name": "JOHNSON",
            "credential": "FNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Loraine Oweela Johnson Davis
• Deborah Jean Johnson Hayes, LCSW
• Fred Johnson Jr.
• Johnson Pharmacy Corp
• Phoebe Hannah Johnson-Black, MD
• Ramona Lynn Johnson-Hackett, BS,RTC
• Natasha Johnson-Henderson
• Lajoi Johnson-Huff
• Latonia Johnson-Zachary
• Adrienne Christine Johnson, MD

• Ambulatory Women's Health Care Registered Nurse in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Ambulatory Women's Health Care Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.