MEDICARE: JESIKA JOHNSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	106E00000X	Assistant Behavior Analyst
2	103K00000X	Behavior Analyst
3	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1902574668
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESIKA JOHNSON

Provider Business Mailing Address
First Line	:	7108 S KANNER HWY
Second Line	:
City	:	STUART
State	:	FL
Zip	:	34997-7462
Country	:	US
Telephone Number	:	855-832-6727
Fax Number	:

Provider Business Practice Location Address
First Line	:	310 E MAGNOLIA ST UNIT 101
Second Line	:
City	:	BELLINGHAM
State	:	WA
Zip	:	98225-4580
Country	:	US
Telephone Number	:	360-820-5835
Fax Number	:	425-740-0741

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

Provider Enumeration Date	:	08/30/2021
Last Update Date	:	09/17/2025

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Directions to “ JESIKA JOHNSON ” Practice Location

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