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NPI Code Detail

MEDICARE: ERICA JOHNSON

MEDICARE: ERICA 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
1133V00000XRegistered Dietitian

General Provider Information

NPI Number : 1770241218
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERICA JOHNSON
Provider Business Mailing Address
First Line : 16715 LUCKY BELL LN
Second Line :
City : CHAGRIN FALLS
State : OH
Zip : 44023-5125
Country : US
Telephone Number : 216-401-0335
Fax Number :
Provider Business Practice Location Address
First Line : 400 MOBIL AVE STE D9
Second Line :
City : CAMARILLO
State : CA
Zip : 93010-6376
Country : US
Telephone Number : 216-401-0335
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2021
Last Update Date : 05/13/2026

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