Doctor Name: | SEAN JOHNSON |
NPI Number: | 1023492352 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 1366 Rock Springs Rd Escondido, CA - 920262223 |
Business Phone Number: | 5303301078 |
Business Fax Number: | |
Mailing Address: | 1366 Rock Springs Rd, ESCONDIDO |
State: | CA |
Postal Code: | 920262223 |
Phone Number: | 5303301078 |
Fax Number: | |
NPI Enumeration Date: | 07/16/2015 |
NPI Last Update Date: | 07/16/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041S0200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | School |
Taxonomy Definition: |