MEDICARE: DEANNA C JOHNSON ASW

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
1	104100000X	Social Worker	ASW 14904	CA

General Provider Information

NPI Number	:	1811002975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEANNA C JOHNSON ASW

Provider Business Mailing Address
First Line	:	811 GRAND AVE
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95838-3466
Country	:	US
Telephone Number	:	916-922-9868
Fax Number	:	916-922-7342

Provider Business Practice Location Address
First Line	:	811 GRAND AVE
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95838-3466
Country	:	US
Telephone Number	:	916-922-9868
Fax Number	:	916-922-7342

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

Provider Enumeration Date	:	08/20/2006
Last Update Date	:	07/08/2007

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Directions to “ DEANNA C JOHNSON ASW” Practice Location

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