IndividualActive
Pamela Johnson
NPI 1619860020 · Custodial Care Facility · Santa Rosa, CA
Provider details
- NPI number
- 1619860020
- Entity type
- Individual
- Primary specialty
- Custodial Care FacilityNursing & Custodial Care Facilities
- Sex
- Female
- Sole proprietor
- Yes
- License
- 4968013672 (CA)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
6360 Old Redwood Hwy
Santa Rosa, CA 95403-1125
Phone: (707) 836-7777
Fax: (707) 838-0820
Approximate (ZIP-level) locationGet directions
Mailing address
6360 Old Redwood Hwy
Santa Rosa, CA 95403-1125
Registry dates
- Enumerated
- 2025-06-03
- Last updated
- 2025-08-29
- Certified
- 2025-08-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.