| Doctor Name: | LORI JOHNSON |
| NPI Number: | 1003103268 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | B.A. |
| License Number: | |
| Business Practice Address: | 160 W Cerritos Ave Anaheim, CA - 928056546 |
| Business Phone Number: | 7146876740 |
| Business Fax Number: | |
| Mailing Address: | 225 Duranzo Aisle, IRVINE |
| State: | CA |
| Postal Code: | 926068359 |
| Phone Number: | 7143155587 |
| Fax Number: | |
| NPI Enumeration Date: | 07/07/2011 |
| NPI Last Update Date: | 07/07/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC2200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical Child & Adolescent |
| Taxonomy Definition: | |