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

Mr. Jan Ronald Johnson, PT

Individual provider Physical Therapist · NPI 1295784510

Mr. Jan Ronald Johnson, PT is a Physical Therapist in Private Practice in South Lake Tahoe, California. Qualified in 1974, 52 years ago. Practices as a sole proprietor. Licensed in California.

Years since qualifying
52
Licensed in
CA
In the registry since
2006
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

2249 Sierra House Trl
South Lake Tahoe, CA 96150-6830
Phone: (530) 542-5750
Fax: (530) 542-5752
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 6891 (CA)

Record details

NPI number1295784510
Entity typeIndividual (Type 1)
GenderMale
Credentials PT
Sole proprietorYes
NPI enumeratedMay 6, 2006
Last updated in NPPESJuly 14, 2025
Certification dateJuly 14, 2025

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 1974 (52 years in practice)
Accepts Medicare assignment Not indicated

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