Active NPI
Lasunea Johnson
- Intellectual and/or Developmental Disabilities Residential Treatment Facility
- Los Angeles, CA
National Provider Identifier
1821861147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual and/or Developmental Disabilities Residential Treatment Facility
- License
- 198320207
- Practice address
- 202 E 108TH St
Los Angeles, CA 90061-2504 - Phone
- (310) 988-6423
- NPI assigned
- Oct 30, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Residential Treatment Facility | 320600000X | 198320207 | CA | Primary |
Addresses
Primary practice location
202 E 108TH St
Los Angeles, CA 90061-2504
Mailing address
202 E 108TH St
Los Angeles, CA 90061-2504
Phone (310) 988-6423
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 198320207 | CA | MD | Intellectual and/or Developmental Disabilities Residential Treatment Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1698624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698710400000",
"number": "1821861147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "202 E 108TH ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900612504",
"telephone_number": "310-988-6423"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "202 E 108TH ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900612504",
"telephone_number": "310-988-6423"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "LASUNEA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-10-30",
"last_updated": "2023-10-31",
"certification_date": "2023-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "320600000X",
"taxonomy_group": "",
"desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
"state": "CA",
"license": "198320207",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.