Doctor Name: | ERIC W JOHNSON |
NPI Number: | 1023338423 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PSY.D. |
License Number: | PS016730 |
Business Practice Address: | 14780 W. Mountain View Blvd. Suite 110 Surprise, AZ - 853747280 |
Business Phone Number: | 6233747774 |
Business Fax Number: | |
Mailing Address: | 14780 W. Mountain View Blvd., Suite 110 SURPRISE |
State: | AZ |
Postal Code: | 853747280 |
Phone Number: | 6023183584 |
Fax Number: | |
NPI Enumeration Date: | 06/08/2010 |
NPI Last Update Date: | 07/15/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PS016730 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |