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General NPI Number Information
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NPI Number | 1366048266
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Entity Type | Individual
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Provider Name | KATRINA LLANILLO JOHNSON BCBA
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Gender | Female
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Dates
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Enumeration Date | 12/07/2020
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Last Update Date | 10/25/2024
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Provider Practice Location Address
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Address Line | 183 BUTCHER RD STE B
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City | VACAVILLE
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State | CA
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Zip | 95687-5691
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Country | US
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Telephone | 707-724-6810
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Fax |
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Provider Business Mailing Address
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Address Line | 16941 N EAGLE RIVER LOOP RD
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City | EAGLE RIVER
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State | AK
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Zip | 99577-7824
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Country | US
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Telephone | 907-206-4421
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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