Andre L Johnson, is a
Student In An Organized Health Care Education/training Program based in Tarzana, California. Andre L Johnson is licensed to practice in * (Not Available) (license number ) and his current practice location is
18646 Oxnard St, Tarzana, California. He can be reached at his office (for appointments etc.) via phone at
(818) 654-3908.
NPI number for Andre L Johnson is 1730857871 and his current mailing address is 1121 E Mcnichols Rd, Detroit, Michigan. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1730857871.
Healthcare Provider's Profile
| Full Name | Andre L Johnson |
|---|
| Gender | Male |
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| Speciality | Student In An Organized Health Care Education/training Program |
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| Location | 18646 Oxnard St, Tarzana, California |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1730857871
- Provider Enumeration Date: 09/02/2021
- Last Update Date: 07/18/2022
Medical Identifiers
Medical identifiers for Andre L Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1730857871 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103T00000X | Psychologist | 6301018288 (Michigan) | Secondary |
| 103TC0700X | Psychologist - Clinical | 6301018288 (Michigan) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Andre L Johnson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Andre L Johnson,
1121 E Mcnichols Rd,
Detroit, MI 48203-2857
Ph: (313) 212-2998 | Andre L Johnson,
18646 Oxnard St,
Tarzana, CA 91356-1411
Ph: (818) 654-3908 |
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