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NPI Code Detail

MEDICARE: REBECCA J JOHNSON LCSW 29018

MEDICARE: REBECCA J JOHNSON LCSW 29018
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
11041C0700XClinical Social Worker29018CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
129018OTHERCALCSW

General Provider Information

NPI Number : 1306061668
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA J JOHNSON LCSW 29018
Provider Business Mailing Address
First Line : 3350 LA JOLLA VILLAGE DR # 122
Second Line :
City : SAN DIEGO
State : CA
Zip : 92161-0002
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3350 LA JOLLA VILLAGE DR
Second Line : #122
City : SAN DIEGO
State : CA
Zip : 92161-0002
Country : US
Telephone Number : 619-400-5157
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2007
Last Update Date : 12/10/2025

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Directions to “ REBECCA J JOHNSON LCSW 29018” Practice Location

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