Individual ProviderSpencer JohnsonStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address1313 E Herndon Ave, Fresno, CA 93720-3306(559) 450-6248PECOS EnrollmentBased on the most recent information from CMS, provider Spencer Johnson does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1477257814Provider TypeIndividualFull NameJohnson, SpencerCredentialMDGenderMaleSole ProprietorNoEnumeration Date3/29/2023Last Updated3/29/2023Contact InformationPractice LocationPractice Address1313 E Herndon Ave, Fresno, CA 93720-3306Phone(559) 450-6248FaxUnlisted FaxMailing LocationMailing Address13308 Perry Ct, Visalia, CA 93292-9389PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer