Individual ProviderVanessa JohansenStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address3800 W Chapman Ave Ste 7300, Orange, CA 92868-1638(317) 607-7489PECOS EnrollmentBased on the most recent information from CMS, provider Vanessa Johansen is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 9:43 AM.Profile DetailsProvider ID1235870171Provider TypeIndividualFull NameJohansen, VanessaGenderFemaleSole ProprietorNoEnumeration Date4/5/2022Last Updated4/5/2022Contact InformationPractice LocationPractice Address3800 W Chapman Ave Ste 7300, Orange, CA 92868-1638Phone(317) 607-7489FaxUnlisted FaxMailing LocationMailing Address3800 W Chapman Ave Ste 7300, Orange, CA 92868-1638PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer