Tara Shantell Johnson, is a
Licensed Practical Nurse based in Corona, California. Tara Shantell Johnson is licensed to practice in California (license number 229904) and her current practice location is
280 Teller St Ste 120, Corona, California. She can be reached at her office (for appointments etc.) via phone at
(909) 825-7084.
NPI number for Tara Shantell Johnson is 1033032057 and her current mailing address is 280 Teller St Ste 120, Corona, California. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1033032057.
Provider's Profile
| Full Name | Tara Shantell Johnson |
|---|
| Gender | Female |
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| Speciality | Licensed Practical Nurse |
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| Location | 280 Teller St Ste 120, Corona, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1033032057
- Provider Enumeration Date: 08/04/2026
- Last Update Date: 10/22/2026
Medical Identifiers
Medical identifiers for Tara Shantell Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1033032057 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 164W00000X | Licensed Practical Nurse | 229904 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Tara Shantell Johnson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Tara Shantell Johnson, 280 Teller St Ste 120, Corona, CA 92879-1888 Ph: (909) 825-7084 | Tara Shantell Johnson, 280 Teller St Ste 120, Corona, CA 92879-1888 Ph: (909) 825-7084 |
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