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NPI Code Detail

MEDICARE: MELVINIA JOHNSON

MEDICARE: MELVINIA JOHNSON
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
1171M00000XCase Manager/Care Coordinator
2172V00000XCommunity Health Worker
3101YA0400XAddiction (Substance Use Disorder) CounselorR1584111024CA

General Provider Information

NPI Number : 1306291869
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELVINIA JOHNSON
Provider Business Mailing Address
First Line : 5233 E BEVERLY BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90022-2020
Country : US
Telephone Number : 323-724-6911
Fax Number :
Provider Business Practice Location Address
First Line : 5233 E BEVERLY BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90022-2020
Country : US
Telephone Number : 323-724-6911
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2016
Last Update Date : 11/19/2024

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Directions to “ MELVINIA JOHNSON ” Practice Location

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