JOHANNA JETTON - NPI 1114430105 - Advanced Practice Midwife in Berkeley, CA

Q: What is Johanna Jetton's NPI number?

The NPI number for Johanna Jetton is 1114430105. It was assigned to this individual provider in the NPPES registry on November 13, 2017.

Q: What is Johanna Jetton's specialty?

The primary specialty registered for this NPI is Advanced Practice Midwife with taxonomy code 367A00000X.

Q: When was this NPI record last updated?

The NPPES record for Johanna Jetton was last updated on March 5, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Johanna Jetton NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JOHANNA JETTON (NPI 1114430105) is an individual advanced practice midwife in Berkeley, California, licensed in California (235935) and active in the NPI registry since November 2017. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2017).

NPPES Registry Identity

NPI1114430105

Entity TypeIndividualFemale

Primary Taxonomy367A00000X

Provider Legal NameJOHANNA JETTON

Location Address2999 REGENT ST STE 524Berkeley, CA 94705-2120

Mailing Address3211 King StBerkeley, CA 94703-2434

Phone(510) 244-0446

Sole ProprietorNo

Medical School CMSOtherGraduated 2017

Enumeration DateNovember 13, 2017

Last NPPES UpdateMarch 5, 20264 updates tracked since enumeration

NPPES CertifiedMarch 5, 2026

✔ NPI 1114430105 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyAdvanced Practice MidwifePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367A00000X

License✔ Licensed in CA · 235935

Definition

Advanced practice midwifery encompasses the independent provision of care during pregnancy, childbirth, and the postpartum period; sexual and reproductive health; gynecologic health; and family planning services, including preconception care. Midwives also provide primary care for individuals from adolescence throughout the lifespan as well as care for the healthy newborn during the first 28 days of life. Midwives provide initial and ongoing comprehensive assessment, diagnosis, and treatment. Midwifery care includes health promotion, disease prevention, risk assessment and management, and individualized wellness education and counseling. Source: American College of Nurse-Midwives, www.midwife.org Additional Resources: See the American College of Nurse-Midwives, www.midwife.org, for more information on Certified Nurse-Midwives, Certified Midwives, the American Midwifery Certification Board (AMCB), and licensure.

Also ListedNurse Practitioner · Obstetrics & GynecologyTaxonomy 363LX0001X · License 95007955 (CA)

2999 REGENT ST STE 524, Berkeley, CA 94705

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Secondary Practice Locations 2

Location 133255 9th StUnion City, CA 94587-2137 · Phone (510) 471-5907

Location 222331 Mission BlvdHayward, CA 94541-3911 · Phone (510) 471-5907

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Johanna Jetton is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9234499807

PECOS Enrollment IDI20260319002699

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94705 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$104.51 typical visit price

range $69.00 – $202.35

Typical copayment $26.12 (range $17.25 – $50.58)

Most-billed visit code 99203

Established Patient

$84.91 typical visit price

range $23.44 – $166.46

Typical copayment $21.22 (range $5.86 – $41.61)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.