Organization · NPI-2

Alyssa Johnston Registered Nursing, INC.

Family Medicine · Roseville, CA

NPI number1740922640
StatusActive
Last updated in NPPESApr 20, 2022

Details

NPI
1740922640
Entity type
Organization (NPI-2)
Legal business name
Alyssa Johnston Registered Nursing, INC.
Organization subpart
No
Enumeration date
Apr 11, 2022
Certification date
Apr 20, 2022
Last updated
Apr 20, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine––Yes
363LF0000X Nurse Practitioner, Family––

Practice location

1814 Cirby Way Apt B
Roseville, CA 95661-5564

Phone 770-876-9602

Mailing address

1814 Cirby Way Apt B
Roseville, CA 95661-5564

Phone 770-876-9602

Other practice locations

125 Ascot Dr Ste B
Roseville, CA 95661-3408

Phone 916-633-2030

Authorized official

Jacob Sung Keum
Attending Physician
7708769602

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