Provider Demographics
NPI:1235984055
Name:JOHNSON, TOMIKA FREDA
Entity type:Individual
Prefix:MS
First Name:TOMIKA
Middle Name:FREDA
Last Name:JOHNSON
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 1:2637 BOWEN RD SE APT 10
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-6638
Mailing Address - Country:US
Mailing Address - Phone:202-749-0321
Mailing Address - Fax:
Practice Address - Street 1:1345 S CAPITOL ST SW APT 703
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-3586
Practice Address - Country:US
Practice Address - Phone:202-793-9825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-23
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant