MEDICARE: MR. JOHNNY FLOERSHEIMER LCSW

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	1041C0700X	Clinical Social Worker		CA

General Provider Information

NPI Number	:	1205087541
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHNNY FLOERSHEIMER LCSW

Provider Business Mailing Address
First Line	:	4240 KEARNY MESA RD
Second Line	:	STE 120, #1076
City	:	SAN DIEGO
State	:	CA
Zip	:	92111
Country	:	US
Telephone Number	:	805-451-6192
Fax Number	:

Provider Business Practice Location Address
First Line	:	4346 TEMECULA ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92107-1126
Country	:	US
Telephone Number	:	805-451-6192
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2008
Last Update Date	:	03/21/2025

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