MEDICARE: KATHERINE 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
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1790641637
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE JOHNSON

Provider Business Mailing Address
First Line	:	3253 W 135TH ST
Second Line	:
City	:	HAWTHORNE
State	:	CA
Zip	:	90250-6340
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8939 S SEPULVEDA BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-3631
Country	:	US
Telephone Number	:	310-795-9737
Fax Number	:

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

Provider Enumeration Date	:	01/05/2026
Last Update Date	:	01/05/2026

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Directions to “ KATHERINE JOHNSON ” Practice Location

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