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General NPI Number Information
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NPI Number | 1912843996
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Entity Type | Individual
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Provider Name | TANYA NICOLE JOHNSON
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Gender | Female
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Dates
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Enumeration Date | 04/24/2026
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Last Update Date | 04/24/2026
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Provider Practice Location Address
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Address Line | 1411 W 190TH ST
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City | GARDENA
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State | CA
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Zip | 90248-4324
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Country | US
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Telephone | 310-719-3908
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Fax |
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Provider Business Mailing Address
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Address Line | 1204 N ORANGE GROVE AVE APT 1204
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90046-5312
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Country | US
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Telephone | 626-772-1463
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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 | CA
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