RANDEL EDWARD JOHANSON (NPI# 1902988074) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902988074 |
| Entity Type | Individual |
| Full Name | RANDEL EDWARD JOHANSON |
| Credential | R.D.O. |
| Practice Address |
1722 Mangrove Ave Suite 32 Chico CA 95926-2300 |
| Practice Telephone | 5308951474 |
| Practice Fax Number | 5308951441 |
| Mailing Telephone | 5308951474 |
| Mailing Fax Number | 5308951441 |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 156FX1800X |
Technician/Technologist Specialization: Optician |
D3437 | CA | Eye and Vision Services Providers |
| Street Address |
1722 MANGROVE AVE SUITE 32 |
| City | CHICO |
| State | CA |
| Zip Code | 95926-2300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104332576 | Asheley Dawn Kimble | Registered Nurse | 592 Lindo Ave, Chico, CA 95926 | 2017-12-21 |
| 1275050635 | Wa Meng Vang | Counselor | 560 Cohasset Rd #180, Chico, CA 95926 | 2017-08-26 |
| 1922538677 | Lisa Ann Milardovich | Physical Medicine & Rehabilitation | 1576 Hawthorne Ave, Chico, CA 95926 | 2017-06-15 |
| 1205364700 | Andrew Vercellino | Chiropractor | 1281 East Ave #100, Chico, CA 95926 | 2017-05-26 |
| 1205389095 | Michele Lando | Social Worker | 572 Rio Lindo Ave Ste 108, Chico, CA 95926 | 2016-07-27 |
| 1215397864 | Joseph Boone Wills IIi | Marriage & Family Therapist | 6 Governors Ln Ste C, Chico, CA 95926 | 2016-02-24 |
| 1356723001 | Erica White | Counselor | 109 Parmac Road, Suite 1, Chico, CA 95926 | 2015-06-18 |
| 1902285208 | Genuine Dbt Licensed Clinical Social Worker Inc | Psychologist | 1140 Mangrove Ave Ste D, Chico, CA 95926 | 2015-05-20 |
| 1255724324 | Linda K Zimbelman | Nurse Practitioner | 1645 Esplanade #1, Chico, CA 95926 | 2015-03-12 |
| 1366851040 | Jose Mendoza | Counselor | 590 Rio Lindo Avenue, Chico, CA 95926 | 2014-08-07 |
| Find all providers in zip 95926 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780214403 | Gary Alan Bates | Technician/Technologist | 2540 Zanella Way Ste 10, Chico, CA 95928-7194 | 2020-01-22 |
| 1396376026 | Bates Opticians | Technician/Technologist | 120 Independence Cir, Chico, CA 95973-4925 | 2020-01-31 |
| 1992881197 | Walmart Stores, Inc. | Technician/Technologist | 2044 Forest Ave, Chico, CA 95928-7619 | 2006-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699374744 | John Dibos | Technician/Technologist | 343 W Felicita Ave Ste 10, Escondido, CA 92025-6515 | 2020-10-20 |
| 1720686140 | Lens 4 Less Optical, Inc. | Technician/Technologist | 343 W Felicita Ave # 10, Escondido, CA 92025-6515 | 2020-10-16 |
| 1023620648 | Blanca Estela Maldonado | Technician/Technologist | 671 E Cooley Dr Ste 102, Colton, CA 92324-4014 | 2020-08-17 |
| 1619598406 | Heather Siu Shum | Technician/Technologist | 200 E Garvey Ave Ste 109, Monterey Park, CA 91755-1859 | 2020-05-03 |
| 1932738481 | Enrique Metta Fallena | Technician/Technologist | 651 Palomar St Ste A17, Chula Vista, CA 91911-2663 | 2020-04-06 |
| 1629603659 | Linh Lai | Technician/Technologist | 1111 Story Rd Ste 1079, San Jose, CA 95122-2670 | 2020-03-10 |
| 1548895998 | Randy Liu | Technician/Technologist | 1049 Capen Ave, Walnut, CA 91789-3912 | 2020-03-05 |
| 1336787696 | Michael Yoshio Sujishi | Technician/Technologist | 150 West Carson Street, Store 8839, Carson, CA 90745 | 2019-12-18 |
| 1609413665 | Yan Zlatin | Technician/Technologist | 21001 Sherman Way # 14a, Canoga Park, CA 91303-1760 | 2019-12-09 |
| 1841837929 | Bushra Abraham | Technician/Technologist | 2370 Crenshaw Blvd Ste I-1, Torrance, CA 90501-3352 | 2019-12-07 |
| Find all providers with the same taxonomy | ||||
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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.