Provider Demographics
NPI:1114646866
Name:SAMAYOA, JOHANA
Entity type:Individual
Prefix:
First Name:JOHANA
Middle Name:
Last Name:SAMAYOA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:782 CALMAE DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93535-3232
Mailing Address - Country:US
Mailing Address - Phone:661-406-0100
Mailing Address - Fax:
Practice Address - Street 1:9517 REA AVE
Practice Address - Street 2:
Practice Address - City:CALIFORNIA CITY
Practice Address - State:CA
Practice Address - Zip Code:93505-4831
Practice Address - Country:US
Practice Address - Phone:661-406-0100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-25
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist