=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184589285
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | A PATH FORWARD INITIATIVE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/20/2025
-----------------------------------------------------
Last Update Date | 12/20/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8530 BURNET AVE UNIT 109
-----------------------------------------------------
City | NORTH HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91343-6084
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 626-788-6769
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8530 BURNET AVE UNIT 109
-----------------------------------------------------
City | NORTH HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91343-6084
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 626-788-6769
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO/CHIEF
-----------------------------------------------------
Name | TINA MARIE SWAYNE JOHNSON
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 626-788-6769
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251B00000X
-----------------------------------------------------
Taxonomy Name | Case Management Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------