MEDICARE: SAVANNA JOHNSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	103K00000X	Behavior Analyst
2	172V00000X	Community Health Worker
3	373H00000X	Day Training/Habilitation Specialist

General Provider Information

NPI Number	:	1073352175
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAVANNA JOHNSON

Provider Business Mailing Address
First Line	:	240 EDMONDS RD BLDG D
Second Line	:
City	:	REDWOOD CITY
State	:	CA
Zip	:	94062-3813
Country	:	US
Telephone Number	:	605-209-1100
Fax Number	:

Provider Business Practice Location Address
First Line	:	240 EDMONDS RD BLDG D
Second Line	:
City	:	REDWOOD CITY
State	:	CA
Zip	:	94062-3813
Country	:	US
Telephone Number	:	605-209-1100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2024
Last Update Date	:	03/04/2026

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Directions to “ SAVANNA JOHNSON ” Practice Location

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