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NPI Code Detail

MEDICARE: SARAH CHRISTEEN JOHNSON BCBA

MEDICARE: SARAH CHRISTEEN JOHNSON BCBA
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
1103K00000XBehavior Analyst
2251S00000XCommunity/Behavioral Health Agency
3103K00000XBehavior Analyst1-20-46493CA

General Provider Information

NPI Number : 1881102879
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH CHRISTEEN JOHNSON BCBA
Provider Business Mailing Address
First Line : 1650 SPRUCE ST STE 250
Second Line :
City : RIVERSIDE
State : CA
Zip : 92507-7429
Country : US
Telephone Number : 760-815-7772
Fax Number :
Provider Business Practice Location Address
First Line : 1650 SPRUCE ST STE 250
Second Line :
City : RIVERSIDE
State : CA
Zip : 92507-7429
Country : US
Telephone Number : 760-815-7772
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2018
Last Update Date : 11/06/2024

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