GARY ANDREW JOHANSON (NPI# 1215043229) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215043229 |
| Entity Type | Individual |
| Full Name | GARY ANDREW JOHANSON |
| Credential | M.D. |
| Practice Address |
500 Doyle Park Dr Suite G04 Santa Rosa CA 95405-4558 |
| Practice Telephone | 7075738984 |
| Practice Fax Number | 7075730982 |
| Mailing Telephone | 7075738984 |
| Mailing Fax Number | 7075730982 |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2011-07-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | G32438 | CA | Allopathic & Osteopathic Physicians |
| Y | 207QH0002X |
Family Medicine Specialization: Hospice and Palliative Medicine |
G32438 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | TAX ID | 680479679 | 01 |
| CA | TAX ID# AS OF 9/1/2010 | 33-0185031 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700836418 | Gary R Johanson | Registered Nurse | 1950 E Clark St, Suite G, Pocatello, ID 83201-3314 | 2006-05-11 |
| Street Address |
500 DOYLE PARK DR SUITE G04 |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95405-4558 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871599852 | David Finnigan | Pediatrics | 500 Doyle Park Dr, Santa Rosa, CA 95405-4558 | 2005-06-23 |
| 1659807170 | Peter Chang-sing, Md | Internal Medicine | 500 Doyle Park Dr, Suite 302, Santa Rosa, CA 95405-4558 | 2017-05-03 |
| 1255738803 | Adventist Health Physicians Network | Clinic/Center | 500 Doyle Park Dr, Suite 106a, Santa Rosa, CA 95405-4558 | 2014-11-25 |
| 1528481983 | Northern California Medical Assoc Inc | Obstetrics & Gynecology | 500 Doyle Park Dr, Ste 103, Santa Rosa, CA 95405-4559 | 2014-01-21 |
| 1073857439 | Allison Cali Paine | Pediatrics | 500 Doyle Park Dr, Suite 100, Santa Rosa, CA 95405-4558 | 2012-11-23 |
| 1154685121 | Jonathan Michael Kurss | Obstetrics & Gynecology | 500 Doyle Park Dr, Suite 200, Santa Rosa, CA 95405-4558 | 2012-06-25 |
| 1619236452 | Northern California Minimally Invasive Cardiovascular Surgery Inc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 500 Doyle Park Dr, Suite G-05, Santa Rosa, CA 95405-4558 | 2012-05-14 |
| 1578838298 | Jennifer Ellen Johnson Byer | Obstetrics & Gynecology | 500 Doyle Park Dr, Suite G06, Santa Rosa, CA 95405-4558 | 2012-03-13 |
| 1023397155 | Cynthia R. Ingels | Nurse Practitioner | 500 Doyle Park Dr, Suite 103, Santa Rosa, CA 95405-4558 | 2011-08-07 |
| 1598051575 | Dina Vaynberg | Obstetrics & Gynecology | 500 Doyle Park Dr, Santa Rosa, CA 95405-4558 | 2011-06-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083230486 | Lizett Camacho | Counselor | 145o Neotomas Avenue Suite 200, Santa Rosa, CA 95405 | 2020-06-22 |
| 1346768918 | Ingrid Tsong | Student in an Organized Health Care Education/Training Program | 3447 Summerfield Road, Santa Rosa, CA 95405 | 2017-09-05 |
| 1275051898 | Jessica Peters Malmberg | Student in an Organized Health Care Education/Training Program | 2447 Summerfield Rd, Santa Rosa, CA 95405 | 2017-09-04 |
| 1306246772 | Kirsten Eckert | Advanced Practice Midwife | 500 Doyle Park Dr Suite 103, Santa Rosa, CA 95405 | 2014-09-03 |
| 1982034294 | Mohammad Reza Saeidi | Dentist | 1820 Sonoma Ave Ste 90a, Santa Rosa, CA 95405 | 2013-11-22 |
| 1851631642 | Debi M. Emmons | Marriage & Family Therapist | 2447 Summerfield Dr, Social Advocates for Youth, Santa Rosa, CA 95405 | 2013-02-15 |
| 1841549979 | Karie Louise Klim | Marriage & Family Therapist | 182 Farmers Ln Ste 204, Santa Rosa, CA 95405 | 2012-09-05 |
| 1427314400 | Rachel E. Page | Counselor | 2447 Summerfield Rd., Santa Rosa, CA 95405 | 2012-04-04 |
| 1689991572 | Center for Integral Healing Inc. | Community Health Worker | 182 Farmers Lane, #203, Santa Rosa, CA 95405 | 2010-04-30 |
| 1588997647 | Kai Morgan | Dentist | 1144 Suite 116 Soonoma Ave, Santa Rosa, CA 95405 | 2009-09-08 |
| Find all providers in zip 95405 | ||||
| Taxonomy Code | 207QH0002X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Hospice and Palliative Medicine |
| A family medicine physician with special knowledge and skills to prevent and relieve the suffering experienced by patients with life-limiting illnesses. This specialist works with an interdisciplinary hospice or palliative care team to maximize quality of life while addressing physical, psychological, social and spiritual needs of both patient and family throughout the course of the disease, through the dying process, and beyond for the family. This specialist has expertise in the assessment of patients with advanced disease; the relief of distressing symptoms; the coordination of interdisciplinary patient and family-centered care in diverse venues; the use of specialized care systems including hospice; the management of the imminently dying patient; and legal and ethical decision making in end-of-life care. |
| Notes: Source: American Academy of Hospice and Palliative Medicine, www.aahpm.org [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821617978 | St. Joseph Home Care Network | Family Medicine | 447 College Ave, Santa Rosa, CA 95401-5141 | 2020-04-09 |
| 1487916045 | Austin Sue | Family Medicine | 500 Doyle Park Dr Ste G04, Santa Rosa, CA 95405 | 2012-06-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639704604 | Rose Desert Hospice | Family Medicine | 42156 10th St W Ste 106, Lancaster, CA 93534-7025 | 2020-03-10 |
| 1033765060 | John C Nelson Md Inc | Family Medicine | Hospice of Humboldt, 3327 Timber Fall Court, Eureka, CA 95503 | 2019-08-15 |
| 1083145247 | Michael J Cortez Md Inc | Family Medicine | 826 Alberta St, Altadena, CA 91001-5322 | 2017-03-21 |
| 1760735492 | Devader Medical & Research Group,inc. | Family Medicine | 175 N Redwood Dr, Suite 275, San Rafael, CA 94903-1972 | 2012-10-18 |
| 1306197520 | Eunice Kim | Family Medicine | 25941 Campo Cv, Loma Linda, CA 92354-6531 | 2012-09-27 |
| 1114155215 | Mook-lan Sauvignon Iglowitz | Family Medicine | 4150 V Street Suite 3400, Palliative Care Department, Sacramento, CA 95817 | 2009-06-26 |
| 1063672244 | Satya Chelamkuri | Family Medicine | El Camino Hospital, 2500 Grant Road, Mountain View, CA 94040 | 2008-06-11 |
| 1053528455 | Richard Marc Goldstein | Family Medicine | 1920 E Katella Ave Ste U, Orange, CA 92867-5146 | 2007-05-16 |
| 1386866689 | Michelle A Thomas Md Inc | Family Medicine | 6061 N First, Suite 102, Fresno, CA 93729 | 2007-05-03 |
| 1912128695 | Bijan Badihian | Family Medicine | 995 W. Foothill Blvd., Claremont, CA 91711-3304 | 2007-05-01 |
| Find all providers with the same taxonomy | ||||
| City | SANTA ROSA |
| Zip Code | 95405 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.