Provider Demographics
NPI:1033901574
Name:JOHNS, EARL JAMES YBANEZ (NP)
Entity type:Individual
Prefix:
First Name:EARL JAMES
Middle Name:YBANEZ
Last Name:JOHNS
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:975 CRESPI DR
Mailing Address - Street 2:
Mailing Address - City:PACIFICA
Mailing Address - State:CA
Mailing Address - Zip Code:94044-3557
Mailing Address - Country:US
Mailing Address - Phone:650-438-5438
Mailing Address - Fax:
Practice Address - Street 1:340 LORTON AVE STE 210
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-4126
Practice Address - Country:US
Practice Address - Phone:773-960-0293
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-20
Last Update Date:2025-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95223998163WP0807X
CA95035796363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent