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

Keena Johnson-Bolden, FNP-BC

Individual provider Registered Nurse · NPI 1780136820

Keena Johnson-Bolden, FNP-BC is a Nurse Practitioner in Los Angeles, California. Qualified in 2015, 11 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
11
Licensed in
CA
In the registry since
2016
Specialties on file
2
What do these letters mean?
FNP-BC — Family Nurse Practitioner, Board Certified
A family nurse practitioner certified by the ANCC.

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Practice location Address checks out

400 W 30th St
Los Angeles, CA 90007-3320
Phone: (213) 284-3200
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Ambulatory Women's Health Care Registered Nurse (primary) Taxonomy 163WW0101X · Licence 95003776 (CA)
Registered Nurse Taxonomy 163W00000X · Licence 634327 (CA)

Record details

NPI number1780136820
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-BC
Sole proprietorNo
NPI enumeratedOctober 25, 2016
Last updated in NPPESAugust 7, 2025
Certification dateAugust 7, 2025

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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