Provider Demographics
NPI:1013382761
Name:JOHNSON- KING, MONICA SHAWN
Entity Type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:SHAWN
Last Name:JOHNSON- KING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18527 E FRONT ST
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:CA
Mailing Address - Zip Code:95236-9703
Mailing Address - Country:US
Mailing Address - Phone:209-204-5379
Mailing Address - Fax:
Practice Address - Street 1:18527 E FRONT ST
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:CA
Practice Address - Zip Code:95236-9703
Practice Address - Country:US
Practice Address - Phone:209-687-5119
Practice Address - Fax:209-887-3815
Is Sole Proprietor?:No
Enumeration Date:2015-12-07
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator