Provider Information for 1659952075
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Mrs. SUSAN JEAN JOHNSTON LMFT, LMHC
Sex: Female
NPI: 1659952075
Last Updated: 2022-01-13
Certification Date: 2022-01-13
Certification Date: 2022-01-13
Details
| Name | Value | ||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1659952075 | ||||||||||||||||
| Enumeration Date | 2021-04-16 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | NO | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 8727 BEACON WOODS PL FORT WAYNE, IN 46804-2688 United States Phone: 260-210-0886 | Fax: | ||||||||||||||||
| Primary Practice Address | 10200 SEPULVEDA BLVD STE 180 MISSION HILLS, CA 91345-2654 United States Phone: 260-210-0886 | Fax: | ||||||||||||||||
| Secondary Practice Address(es) | 8727 BEACON WOODS PL | ||||||||||||||||
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