Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Michael Alan Johnson, DPM

Individual provider Podiatrist · NPI 1205847209

Dr. Michael Alan Johnson, DPM is a Podiatry in Petaluma, California. Qualified in 1989, 37 years ago. Practices with Providence Medical Foundation, a 1,465-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
37
Licensed in
CA
In the registry since
2006
What do these letters mean?
DPM — Doctor of Podiatric Medicine
A foot and ankle physician and surgeon.

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Practice location Address checks out

108 Lynch Creek Way Ste 3
Petaluma, CA 94954
Phone: (707) 763-2253
Fax: (707) 763-7030
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Podiatrist (primary) Taxonomy 213E00000X · Licence E3671 (CA)

Record details

NPI number1205847209
Entity typeIndividual (Type 1)
GenderMale
Credentials DPM
Sole proprietorYes
NPI enumeratedAugust 11, 2006
Last updated in NPPESNovember 3, 2021
Certification dateNovember 3, 2021
Mailing address108 Lynch Creek Way, Suite 3, Petaluma, CA 94954

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPODIATRY
Medical schoolOTHER
Graduated 1989 (37 years in practice)
Group practice Providence Medical Foundation — 1465 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Petaluma