Provider Demographics
NPI:1760237929
Name:JOHNSON, ERICA DIANNE
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:DIANNE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:ERICA
Other - Middle Name:DIANNE
Other - Last Name:HUTTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:590 RIO LINDO AVE
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-1817
Mailing Address - Country:US
Mailing Address - Phone:530-897-0562
Mailing Address - Fax:
Practice Address - Street 1:590 RIO LINDO AVE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-1817
Practice Address - Country:US
Practice Address - Phone:530-897-0562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-22
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)