Individual
JACQUELINE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3200 LONG BEACH BLVD, LONG BEACH, CA 90807-5062
(562) 548-6500
Mailing address
3200 LONG BEACH BLVD, LONG BEACH, CA 90807-5062
(562) 548-6500
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
ACSW123748
CA
1041C0700X
Clinical Social Worker
—
CA
Other
Enumeration date
09/14/2022
Last updated
08/20/2024
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