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NPI Code Detail

MEDICARE: CEZANNE GONZALES JOHNSON BCBA

MEDICARE: CEZANNE GONZALES JOHNSON BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst1-26-87055CO

General Provider Information

NPI Number : 1194679647
Entity Type Code : Individual
Provider Name (Legal Business Name) : CEZANNE GONZALES JOHNSON BCBA
Provider Business Mailing Address
First Line : 348 EDDY DR APT 2107
Second Line :
City : GRAND JUNCTION
State : CO
Zip : 81501-4729
Country : US
Telephone Number : 970-589-7035
Fax Number :
Provider Business Practice Location Address
First Line : 543 31 RD
Second Line :
City : GRAND JUNCTION
State : CO
Zip : 81504-5772
Country : US
Telephone Number : 970-549-2303
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2026
Last Update Date : 02/23/2026

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