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Individual
TANESHIA JOHNSON
Active
Individual
TANESHIA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
12849
CA
101YA0400X
Addiction (Substance Use Disorder) Counselor
A051020319
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12849
SUDCC
CA
01
—
A051020319
CCAPP
CA
Enumeration date
05/01/2017
Last updated
05/24/2022
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