Healthcare Provider Details

I. General information

NPI: 1699236521
Provider Name (Legal Business Name): TRAMANE J JOHNSON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2019
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6950 65TH ST
SACRAMENTO CA
95823-2316
US

IV. Provider business mailing address

7105 6TH PKWY
SACRAMENTO CA
95823-2201
US

V. Phone/Fax

Practice location:
  • Phone: 916-807-3513
  • Fax:
Mailing address:
  • Phone: 916-807-3513
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: