Most Relevant Information
Provider Data
| NPI Number: | 1003468661 |
| Provider Name: | TAMYRA DANICA JOHNSON |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/14/2019 |
| Last Updated: | 07/14/2019 |
Provider Practice Location
1918 UNIVERSITY AVE STE 2B
BERKELEY
CA
947043264
Practice Location Phone/Fax
| Phone: | 5108411262 |
| Fax: |
Provider Mailing Location
1918 UNIVERSITY AVE STE 2B
BERKELEY
CA
947043264
Provider Mailing Phone/Fax
| Phone: | 5108411262 |
| Fax: |