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NPI Code Detail

MEDICARE: SHANEKKA NICOLE BROWN-JOHNSON LMFT

MEDICARE: SHANEKKA NICOLE BROWN-JOHNSON LMFT
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family TherapistAMFT110512CA
2106H00000XMarriage & Family TherapistLMFT145841CA
3106H00000XMarriage & Family Therapist5162-RNV
4172V00000XCommunity Health WorkerAMFT110512CA
5106H00000XMarriage & Family Therapist238586AK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1528629623
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANEKKA NICOLE BROWN-JOHNSON LMFT
Provider Business Mailing Address
First Line : 1985 DEL AMO BLVD # P1431
Second Line :
City : TORRANCE
State : CA
Zip : 90501-1304
Country : US
Telephone Number : 860-469-5439
Fax Number :
Provider Business Practice Location Address
First Line : 5588 N PALM AVE
Second Line :
City : FRESNO
State : CA
Zip : 93704-1913
Country : US
Telephone Number : 860-469-5439
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2019
Last Update Date : 01/21/2026

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Directions to “ SHANEKKA NICOLE BROWN-JOHNSON LMFT” Practice Location

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