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NPI Code Detail

MEDICARE: SASHA JOHNSON

MEDICARE: SASHA 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

General Provider Information

NPI Number : 1942672639
Entity Type Code : Individual
Provider Name (Legal Business Name) : SASHA JOHNSON
Provider Business Mailing Address
First Line : 6015 HEARNE AVE
Second Line :
City : SHREVEPORT
State : LA
Zip : 71108-3803
Country : US
Telephone Number : 318-213-0904
Fax Number :
Provider Business Practice Location Address
First Line : 6015 HEARNE AVE
Second Line :
City : SHREVEPORT
State : LA
Zip : 71108-3803
Country : US
Telephone Number : 318-213-0904
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/21/2015
Last Update Date : 07/02/2022

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Directions to “ SASHA JOHNSON ” Practice Location

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