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Edith Garcia-Trujillo Johannes

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

10833 Le Conte Ave, Los Angeles, CA 90095-3075

PECOS Enrollment

This provider is enrolled in PECOS as EDITH JOHANNES.

Based on the most recent information from CMS, provider Edith Garcia-Trujillo Johannes is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records today at 11:47 AM.

Profile Details

Provider ID
1154508430
Provider Type
Individual
Full Name
Johannes, Edith Garcia-Trujillo
Credential
NP

Gender
Female
Sole Proprietor
No
Enumeration Date
1/29/2008
Last Updated
1/14/2020

Contact Information

Practice Location

10833 Le Conte Ave, Los Angeles, CA 90095-3075

(310) 206-3748

Unlisted Fax

Mailing Location

5767 W Century Blvd Ste 400, Los Angeles, CA 90045-5631

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363L00000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License NP17274 California

Edith Garcia-Trujillo Johannes

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Munier, Timothy Michael

Estrera, Miguel Rodrigo Cruz

Hwang, Vilayphone Thongsithavong

Frias, Giovanni S

Martinez, Erica Suzanne

Chen, Xiamei

Green, Stacey D

Hirofuji, Eri

Geraghty, Kristen Marie

Meneses, Katherine