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

Jervonne Lanee Johnson

Individual provider Family Nurse Practitioner · NPI 1861169252

Jervonne Lanee Johnson is a Nurse Practitioner in Los Angeles, California. Qualified in 2021, 5 years ago. Practices with Medexa Medical Group, Corporation, an 8-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
5
Licensed in
CA
In the registry since
2021
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Practice location Address checks out

5901 W Century Blvd Ste 750
Los Angeles, CA 90045-5443
Phone: (888) 880-3451
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 95018172 (CA)

Record details

NPI number1861169252
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 24, 2021
Last updated in NPPESMay 15, 2024
Certification dateMay 15, 2024

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Medexa Medical Group, Corporation — 8 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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