MR. LARRY WAYNE JOHNSON (NPI# 1396983888) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396983888 |
| Entity Type | Individual |
| Full Name | MR. LARRY WAYNE JOHNSON |
| Credential | C.O. |
| Practice Address |
9570 Ridgehaven Ct Suite C San Diego CA 92123-1667 |
| Mailing Address |
10723 Montego Dr San Diego CA 92124-1910 |
| Practice Telephone | 8582780518 |
| Practice Fax Number | 8582780323 |
| Mailing Telephone | 8585652230 |
| Enumeration Date | 2009-01-22 |
| Last Update Date | 2009-01-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | CO2834 | CA | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801367032 | Larry R Johnson Jr. | Registered Nurse | 5011 State Rd, Fort Gratiot, MI 48059-2909 | 2018-12-16 |
| 1093103491 | Larry Johnson Sr. | Private Vehicle | 600 Lake Air Dr, Suite 3a, Waco, TX 76710-5887 | 2015-01-07 |
| 1578981262 | Larry Johnson | Pharmacist | 18928 Auberry Rd, Clovis, CA 93619-9641 | 2014-03-31 |
| 1841588316 | Larry Brian Johnson | Pharmacist | 37435 Main St, Burney, CA 96013-4372 | 2011-07-18 |
| 1669448155 | Larry Dean Johnson | Chiropractor | 413 Ne Van Loon Ln, #126, Cape Coral, FL 33909-2525 | 2006-02-24 |
| 1932183043 | Larry Wayne Johnson | Family Medicine | 1015 Garden Lake Pkwy, Toledo, OH 43614-2779 | 2005-12-01 |
| 1275514911 | Larry Hugh Johnson | Family Medicine | 7643 Oak Park Pl Nw, Bremerton, WA 98311-9175 | 2005-11-09 |
| 1487203477 | Larry Darnell Johnson | Social Worker | 1030 5th Ave Se Ste 3000, Cedar Rapids, IA 52403-2416 | 2019-09-11 |
| 1902370281 | Larry D Johnson | Counselor | 4300 Sw 13th St, Gainesville, FL 32608-4006 | 2019-01-19 |
| 1417423468 | Larry Johnson | Case Manager/Care Coordinator | 4348 S Jeffrey Dr Ste 102, Baton Rouge, LA 70816-4196 | 2018-10-17 |
| Street Address |
9570 RIDGEHAVEN CT SUITE C |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92123-1667 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669087326 | Corina Lozano Manzo | Registered Nurse | 7436 Mission Center Road, San Diego, CA 92123 | 2020-09-10 |
| 1831703537 | Shannon Leigh Doolittle | Audiologist | 3020 Children's Way Mc5010, San Diego, CA 92123 | 2020-09-01 |
| 1861014359 | Ha Thanh Truong | Pharmacist | Rezcare, 3821 Calle Fortunada, San Diego, CA 92123 | 2020-05-07 |
| 1023667136 | Brittany Meyer | Physical Therapist | 3020 Children's Waymc5068, San Diego, CA 92123 | 2019-09-11 |
| 1598313272 | Ryan Edward Shaw | Marriage & Family Therapist | 8910 Clairmont Mesa Blvd, San Diego, CA 92123 | 2019-08-27 |
| 1528611910 | Tanisha C Fulcher | Marriage & Family Therapist | 8825 Aero Dr., Ste 315, San Diago, CA 92123 | 2019-07-24 |
| 1245795665 | Robin James Pekin | Marriage & Family Therapist | 4450 Kearny Villa Rd, #116, San Diego, CA 92123 | 2019-02-11 |
| 1174093728 | Karen Vences | Counselor | 8755 Aero Dr Suite 230, San Diego, CA 92123 | 2018-11-27 |
| 1255808465 | Natasha Herrera | Counselor | 2801 Meadow Lark Dr, San Diego, San Diego, CA 92123 | 2018-10-25 |
| 1407321987 | Maneka Elikewela | Behavior Technician | 3934 Murphy Canyon Rd, Ste B202, San Diego, CA 92123 | 2018-10-10 |
| Find all providers in zip 92123 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114541463 | Serena Mink | Specialist | 100 Park Plz Apt 407, San Diego, CA 92101-6710 | 2020-06-02 |
| 1023648201 | Pamela Renea Crane | Specialist | 3237 Meade Ave, San Diego, CA 92116-4519 | 2020-01-16 |
| 1184199853 | Oliver Rakeem Taylor | Specialist | 1265 Angelus Ave, San Diego, CA 92114-3108 | 2018-10-09 |
| 1376040923 | Mark Edmond Rierson | Specialist | 2333 1st Ave Ste 106, San Diego, CA 92101-1538 | 2018-04-10 |
| 1790232635 | Cristina Zheng-castruita | Specialist | 9308 Babauta Rd, Apt. 62, San Diego, CA 92129-4922 | 2016-09-08 |
| 1689027955 | Neelam Agashe | Specialist | 3445 Lebon Dr Apt 1215, San Diego, CA 92122-5267 | 2016-07-21 |
| 1376998864 | Briniti Ichull | Specialist | 3941 Kurtz St, San Diego, CA 92110 | 2016-05-03 |
| 1952765935 | Jacqueline Morgan | Specialist | 9625 Black Mountain Rd Ste 300, San Diego, CA 92126-4598 | 2016-04-06 |
| 1710341862 | Comprehensive Medical Reporting Services | Specialist | 9040 Friars Rd., Ste. 410, San Diego, CA 92108 | 2016-04-05 |
| 1790150555 | Mahmood Nazari | Specialist | 6209 Lake Apopka Pl, 6209 Lake Apopka Place, San Diego, CA 92119-3520 | 2015-12-04 |
| Find all providers in SAN DIEGO | ||||
Please comment or provide details below to improve the information on MR. LARRY WAYNE JOHNSON.
| 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.