Tyresha Dane Johnson

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

5614 N Fresno St Ste 111
Fresno, CA 93710-6034

Phone

(832) 836-6326

NPI assigned

Nov 8, 2023

Last updated

Nov 8, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1699401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1457125627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5614 N FRESNO ST STE 111",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937106034",
            "telephone_number": "559-578-0306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5614 N FRESNO ST STE 111",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937106034",
            "telephone_number": "832-836-6326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TYRESHA",
        "middle_name": "DANE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-08",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093588386",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sharon Lorraine Johnson, PH.D.
• Shawn Johnson, DC
• Spencer Johnson, MD
• Theresa J Johnson, RN, IBCLC, RLC
• Tiffany Nicole Lynne Johnson
• Virginia Johnson
• Weniesha Dashawn Johnson, LPCC
• Whitney Ann Johnson, PA-C
• Yasmina Maria Johnson
• Robert A Johnson., CNA

• Community Health Worker in Fresno, CA
• Providers in Fresno, CA by specialty
• Community Health Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.