Provider Demographics
NPI:1316327133
Name:JOHNSON, ROKISHA
Entity type:Individual
Prefix:
First Name:ROKISHA
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5730 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:MARCH ARB
Mailing Address - State:CA
Mailing Address - Zip Code:92518-1867
Mailing Address - Country:US
Mailing Address - Phone:951-655-5167
Mailing Address - Fax:
Practice Address - Street 1:5730 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:MARCH ARB
Practice Address - State:CA
Practice Address - Zip Code:92518-1867
Practice Address - Country:US
Practice Address - Phone:951-655-5167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-06
Last Update Date:2015-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN621013163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse