Provider Information for 1114386018
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
KRYSTAL JOHNSON LCSW
Sex: Female
NPI: 1114386018
Last Updated: 2023-04-07
Certification Date: 2023-04-07
Certification Date: 2023-04-07
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1114386018 | ||||||||
| Enumeration Date | 2016-02-19 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1072 VIEW DR EL SOBRANTE, CA 94803-1250 United States Phone: 510-253-4342 | Fax: | ||||||||
| Primary Practice Address | 4820 BUSINESS CENTER DR FAIRFIELD, CA 94534-1696 United States Phone: 707-977-8635 | Fax: | ||||||||
| Secondary Practice Address(es) | 2310 1ST ST | ||||||||
| Health Information Exchange |
| ||||||||
| Other Identifiers |
| ||||||||
| Taxonomy |
|