Melony Rene Johnson

Individual provider Active NPI Speech-Language Assistant · Dixon, CA

NPI 1043829609 · NPPES record last updated Apr 14, 2023

Key facts

NPI
1043829609
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Assistant 2355S0801X
License
6215 (CA)
Practice address
255 N Lincoln St Ste a
Dixon, CA 95620-3238
Phone
(530) 613-5048
NPI assigned
Jul 29, 2020
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
6215CAMDOptician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X 6215 CA Yes

Addresses

Primary practice location

255 N Lincoln St Ste a
Dixon, CA 95620-3238

Mailing address

255 N Lincoln St Ste a
Dixon, CA 95620-3238

Other providers in Dixon, CA

All providers in Dixon, CA · Speech-Language Assistant in California

Sources for this page

Verify at the official NPI Registry.