Healthcare Provider Details

I. General information

NPI: 1679308316
Provider Name (Legal Business Name): TAWONNA JOHNSON-REED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2024
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8950 CAL CENTER DR BLDG 2
SACRAMENTO CA
95826-3259
US

IV. Provider business mailing address

8950 CAL CENTER DR BLDG 2
SACRAMENTO CA
95826-3259
US

V. Phone/Fax

Practice location:
  • Phone: 916-254-5200
  • Fax:
Mailing address:
  • Phone: 916-254-5200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: