Healthcare Provider Details

I. General information

NPI: 1154759108
Provider Name (Legal Business Name): ERIKA JOHNSON MS, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2013
Last Update Date: 10/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40131 HIGHWAY 49
OAKHURST CA
93644-9560
US

IV. Provider business mailing address

2900 CHARLEVOIX DR SE SUITE 200
GRAND RAPIDS MI
49546-7085
US

V. Phone/Fax

Practice location:
  • Phone: 559-683-2244
  • Fax:
Mailing address:
  • Phone: 616-975-5092
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number13646
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: