Individual provider · Type 1 NPI

Robert Gary Johannsen

Peer Specialist · Lake Isabella, CA

NPI number 1134099088 Active

Practice location

2731 Nugget Ave
Lake Isabella, CA 93240-9456

Call (760) 379-3412 Map

Fax (760) 379-5332

Specialties and licenses

TaxonomyCodeLicense
Peer Specialist Primary 175T00000XMPSS-EKZJXM (CA)

Peer Specialist: Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

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About NPI 1134099088

Robert Gary Johannsen's National Provider Identifier is 1134099088, issued on Nov 6, 2025. The primary taxonomy on file is Peer Specialist (175T00000X), and the practice location is in Lake Isabella, CA. The record was last updated on Nov 6, 2025.