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Individual
MR. MARK L JOHNSON
Active
Individual
MR. MARK L JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY27266
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PSY27266
BOARD OF PSYCHOLOGY LICENSE
CA
Enumeration date
05/21/2012
Last updated
07/27/2016
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