Provider Demographics
NPI:1649660838
Name:SHARON Y JOHNSON &ASSOCIATES
Entity type:Organization
Organization Name:SHARON Y JOHNSON &ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:YVETTE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-607-7693
Mailing Address - Street 1:12706 PARKER LN
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-5130
Mailing Address - Country:US
Mailing Address - Phone:202-607-7693
Mailing Address - Fax:800-583-4953
Practice Address - Street 1:12706 PARKER LN
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-5130
Practice Address - Country:US
Practice Address - Phone:202-607-7693
Practice Address - Fax:800-583-4953
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SHARON Y JOHNSON &ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-01-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0167642211Medicaid