| Sunny Johnson, Licensed Clinical Social Worker, A Professional Corp | |
|
3711 Long Beach Blvd Ste 5043 Long Beach CA 90807-3315 | |
| (562) 452-3373 | |
| (562) 264-0977 |
| Full Name | Sunny Johnson, Licensed Clinical Social Worker, A Professional Corp |
|---|---|
| Speciality | Social Worker |
| Location | 3711 Long Beach Blvd Ste 5043, Long Beach, California |
| Authorized Official Name and Position | Sunny Johnson (CEO) |
| Authorized Official Contact | 5624523373 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sunny Johnson, Licensed Clinical Social Worker, A Professional Corp 3711 Long Beach Blvd Ste 5043 Long Beach CA 90807-3315 Ph: (562) 452-3373 | Sunny Johnson, Licensed Clinical Social Worker, A Professional Corp 3711 Long Beach Blvd Ste 5043 Long Beach CA 90807-3315 Ph: (562) 452-3373 |
| NPI Number | 1558927848 |
|---|---|
| Provider Enumeration Date | 05/13/2019 |
| Last Update Date | 05/13/2019 |
| Medicare PECOS PAC ID | 3577898014 |
|---|---|
| Medicare Enrollment ID | O20190705000568 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558927848 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Sunny Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508158577 PECOS PAC ID: 9830412485 Enrollment ID: I20150106001961 |
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