MEDICARE: DIONTRE 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	101YA0400X	Addiction (Substance Use Disorder) Counselor		CA

General Provider Information

NPI Number	:	1952253031
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIONTRE JOHNSON

Provider Business Mailing Address
First Line	:	2568 BASELINE ST APT 208
Second Line	:
City	:	HIGHLAND
State	:	CA
Zip	:	92346-2846
Country	:	US
Telephone Number	:	909-476-2023
Fax Number	:

Provider Business Practice Location Address
First Line	:	13684 JEREMY CT
Second Line	:
City	:	RANCHO CUCAMONGA
State	:	CA
Zip	:	91739-2031
Country	:	US
Telephone Number	:	909-803-0376
Fax Number	:

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

Provider Enumeration Date	:	02/11/2026
Last Update Date	:	02/12/2026

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Directions to “ DIONTRE JOHNSON ” Practice Location

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