Ronn Mark Johnson (NPI# 1699986000, PAC ID# 2668729732) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PSYCHOLOGIST, CLINICAL.
| Nation Provider ID (NPI) | 1699986000 |
| PAC ID by PECOS | 2668729732 |
| Professional Enrollment ID | I20180719003609 |
| Full Name | Ronn Mark Johnson |
| Organization Legal Name | COSTA CLINICAL PSYCHOLOGY, LLC |
| Address |
625 Spruce St Suite 7666 Brookings OR 97415-0408 |
| Phone Number | 5414120700 |
| Gender | M |
| Graduation Year | 2000 |
| Primary Specialty | PSYCHOLOGIST, CLINICAL |
| Group Practice PAC ID | 2365723186 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 625 Spruce St, Suite 7666, Brookings, OR 97415-0408 | 5414120700 | COSTA CLINICAL PSYCHOLOGY, LLC |
| Organization Legal Name | COSTA CLINICAL PSYCHOLOGY, LLC |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Teresa I Costa | Psychologist, Clinical | Costa Clinical Psychology, LLC | 625 Spruce St, Suite 7666, Brookings, OR 97415-0408 |
| Street Address |
625 SPRUCE ST SUITE 7666 |
| City | BROOKINGS |
| State | OR |
| Zip | 97415-0408 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Teresa I Costa | Psychologist, Clinical | Costa Clinical Psychology, LLC | 625 Spruce St, Suite 7666, Brookings, OR 97415-0408 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Walter S Murphy | Podiatry | 30 Winchuck Rd, Brookings, OR 97415 | |
| Jitendra C Patel | Internal Medicine | 97825 Shopping Ctr Ave, Brookings, OR 97415 | |
| Charles M Bourland | Chiropractic | 524 Spruce St, Suite 5, Brookings, OR 97415-0407 | |
| Jocelyn Gates | Clinical Social Worker | 604 Spruce St, Brookings, OR 97415-0408 | |
| Douglas J Walker | Optometry | Eye Center of Brookings LLC | 937 Chetco Ave, Suite K4005, Brookings, OR 97415-2514 |
| Kristin J Gurholt | Optometry | Eye Center of Brookings LLC | 937 Chetco Ave, Suite K4005, Brookings, OR 97415-2514 |
| Jennifer M Boyle | Nurse Practitioner | 1101 Chetco Ave, Brookings, OR 97415-2515 | |
| William E Mcdougall | Internal Medicine | Oregon Coast Wellness Inc. | 648 Chetco Ave, Brookings, OR 97415-8010 |
| Stacy R Kreger | Nurse Practitioner | Oregon Coast Wellness Inc. | 648 Chetco Ave, Brookings, OR 97415-8010 |
| Susan E Brickley | Physical Therapy | Coastal Physical Therapy LLC | 580 5th St, Suite 600, Brookings, OR 97415-8329 |
| Find all physicians in zip 97415 | |||
| City | BROOKINGS |
| Zip Code | 97415 |
| Specialty | PSYCHOLOGIST, CLINICAL |
| City + Specialty | BROOKINGS + PSYCHOLOGIST, CLINICAL |
Please comment or provide details below to improve the information on Ronn Mark Johnson.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.