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NPI Code Detail

MEDICARE: MRS. RENEE MICHELLE JOHNSON

MEDICARE: MRS. RENEE MICHELLE 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
1101Y00000XCounselor
2101YM0800XMental Health Counselor
3171M00000XCase Manager/Care Coordinator
4225400000XRehabilitation PractitionerCA

General Provider Information

NPI Number : 1497881262
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. RENEE MICHELLE JOHNSON
Provider Business Mailing Address
First Line : 9343 TECH CENTER DR
Second Line :
City : SACRAMENTO
State : CA
Zip : 95826-2563
Country : US
Telephone Number : 530-747-3372
Fax Number : 530-753-0398
Provider Business Practice Location Address
First Line : 3050 BEACON BLVD STE 103
Second Line :
City : WEST SACRAMENTO
State : CA
Zip : 95691-3467
Country : US
Telephone Number : 530-230-1285
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2007
Last Update Date : 06/16/2025

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