KELLY JOHNSON (NPI# 1487702262) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487702262 |
| Entity Type | Individual |
| Full Name | KELLY JOHNSON |
| Practice Address |
205 N Blackstone Ave Fresno CA 93701-1914 |
| Mailing Address |
2110 Helm Ave # 31 Clovis CA 93612-3453 |
| Practice Telephone | 5594980241 |
| Practice Fax Number | 5594986220 |
| Mailing Telephone | 5592921430 |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225400000X | Rehabilitation Practitioner | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023631249 | Kelly Lynn Johnson | Occupational Therapist | 22123 Figueroa St Unit 113, Carson, CA 90745-4464 | 2020-05-21 |
| 1851932404 | Kelly Christine Johnson | Nurse Practitioner | 7319 Stonerock Cir # 106, Orlando, FL 32819-8002 | 2019-10-04 |
| 1083274989 | Kelly Danielle Johnson | Registered Nurse | 76 Dubois Ct Apt D, Englewood, NJ 07631-3439 | 2019-06-13 |
| 1871151365 | Kelly Johnson | Family Medicine | 103 S White Oak Rd, White Oak, TX 75693-1517 | 2019-05-30 |
| 1194288753 | Kelly Mills Johnson | Psychologist | 100 Bush St Ste 918, San Francisco, CA 94104-3950 | 2019-04-10 |
| 1700345345 | Kelly Marlene Johnson | Nurse Practitioner | 1320 E Oklahoma Ave, Guthrie, OK 73044-3757 | 2019-03-13 |
| 1891253597 | Kelly Marie Johnson | Specialist/Technologist | 1472 Mobley Ct, Frederick, MD 21701-9113 | 2019-03-12 |
| 1447744347 | Kelly Theresa Johnson | Speech-Language Pathologist | 5272 River Rd Ste 100, Bethesda, MD 20816-1454 | 2018-06-14 |
| 1962902882 | Kelly M Johnson | Licensed Vocational Nurse | 118 Brazos Ln, Kyle, TX 78640-5289 | 2018-02-16 |
| 1427573476 | Kelly Colleen Johnson | Social Worker | 2530 Meridian Parkway, Suite 300, Pbn: 3071, Durham, NC 27713-2771 | 2017-08-11 |
| Street Address |
205 N BLACKSTONE AVE |
| City | FRESNO |
| State | CA |
| Zip Code | 93701-1914 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760539993 | Lydia Janett Allen | Rehabilitation Practitioner | 205 N Blackstone Ave, Fresno, CA 93701-1914 | 2007-01-03 |
| 1437315819 | Sunday Osho Olusegun | Licensed Vocational Nurse | 205 N Blackstone Ave, Fresno, CA 93701-1914 | 2008-08-05 |
| 1043476534 | Eleanor Cantu Granados | Counselor | 205 N Blackstone Ave, Fresno, CA 93701-1914 | 2008-08-04 |
| 1104978022 | Fresno County Apollo Residential Prog. | Psychiatric Residential Treatment Facility | 205 N Blackstone Ave, Fresno, CA 93701-1914 | 2007-01-18 |
| 1518015007 | Maria C Urrutia | Rehabilitation Practitioner | 205 N Blackstone Ave, Fresno, CA 93701-1914 | 2007-01-08 |
| 1932257417 | Rosa E Negrete | Rehabilitation Practitioner | 205 N Blackstone Ave, Fresno, CA 93701-1914 | 2007-01-08 |
| 1417005273 | Mayra Luz Tienda | Rehabilitation Practitioner | 205 N Blackstone Ave, Fresno, CA 93701-1914 | 2007-01-08 |
| 1821146283 | Mary Ellen Perez | Rehabilitation Practitioner | 205 N Blackstone Ave, Fresno, CA 93701-1914 | 2007-01-08 |
| 1093862500 | Dutch Epperson | Rehabilitation Practitioner | 205 N Blackstone Ave, Fresno, CA 93701-1914 | 2007-01-05 |
| 1043367360 | Lillie Lois Johnson | Rehabilitation Practitioner | 205 N Blackstone Ave, Fresno, CA 93701-1914 | 2007-01-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134740244 | Tamara Sue Stanic | Registered Nurse | 215 N. Fresno Street, Suite 370, Fresno, CA 93701 | 2020-04-29 |
| 1144849829 | Katelyn Nicole Van Leir | Student in an Organized Health Care Education/Training Program | Surabian Dental Care Center - Suite 2500, 290 N. Wayte Lane, Fresno, CA 93701 | 2020-04-13 |
| 1003445693 | Michelle Edwardson | Registered Nurse | 215 North Fresno Street, Suite 370, Fresno, CA 93701 | 2020-04-06 |
| 1184253924 | Patricia Calderon | Registered Nurse | 215 N. Fresno Street, Suite 230, Fresno, CA 93701 | 2020-04-03 |
| 1922637032 | Leticia Lopez | Registered Nurse | 215 N. Fresno Street, Suite 230, Fresno, CA 93701 | 2020-04-02 |
| 1275026585 | Yesenia Gonzalez | Nurse Practitioner | 311 Abby Street, Fresno, CA 93701 | 2018-06-11 |
| 1710474606 | Amanda Juarez | Dietitian, Registered | 215 N Fresno, Suite 370, Fresno, CA 93701 | 2018-04-17 |
| 1235650391 | Plastic Surgery Partners of Fresno Inc | Plastic Surgery | 215 N Fresno St, Ste 490, Fresno, CA 93701 | 2017-06-29 |
| 1205369790 | Amy Alagh | Student in an Organized Health Care Education/Training Program | 155 N Fresno Street, Fresno, CA 93701 | 2017-04-11 |
| 1922462159 | Henry Matthew Dunn | Student in an Organized Health Care Education/Training Program | Ucsf Fresno, 155 N. Fresno St., Department of Orthopaedic Surgery, Fresno, CA 93701 | 2016-04-13 |
| Find all providers in zip 93701 | ||||
| Taxonomy Code | 225400000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Rehabilitation Practitioner |
| A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316472517 | Samantha Ortiz | Rehabilitation Practitioner | 6121 N Thesta St Ste 304, Fresno, CA 93710-5294 | 2017-04-25 |
| 1124292453 | Michael Joseph Downing | Rehabilitation Practitioner | 3017 W Bullard Ave, Fresno, CA 93711-1609 | 2008-04-17 |
| 1760539993 | Lydia Janett Allen | Rehabilitation Practitioner | 205 N Blackstone Ave, Fresno, CA 93701-1914 | 2007-01-03 |
| 1679113898 | Sheila Barth | Rehabilitation Practitioner | 6121 N Thesta St Ste 304, Fresno, CA 93710-5294 | 2020-01-15 |
| 1609379213 | Michelle Brianna Rose Duran | Rehabilitation Practitioner | 4411 E Kings Canyon Rd, Fresno, CA 93702-3604 | 2018-03-10 |
| 1073644761 | Conni Washington | Rehabilitation Practitioner | 3133 N Millbrook Ave, Fresno, CA 93703-1425 | 2007-03-07 |
| 1245360585 | Dale Ray Lacy Jr. | Rehabilitation Practitioner | 3147 N Millbrook Ave, Fresno, CA 93703-1425 | 2007-03-06 |
| 1780713396 | John J Velasco | Rehabilitation Practitioner | 3133 N Millbrook Ave, Fresno, CA 93703-1425 | 2007-03-02 |
| 1730218298 | Yvonne Gravelle | Rehabilitation Practitioner | 3133 N Millbrook Ave, Fresno, CA 93703-1425 | 2007-03-02 |
| 1225166002 | Consuelo Gonzalez-perez | Rehabilitation Practitioner | 3133 N Millbrook Ave, Fresno, CA 93703-1425 | 2007-03-01 |
| Find all providers in FRESNO | ||||
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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.