Individual
AMANDA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1442 VALOTA RD, REDWOOD CITY, CA 94061-2620
(650) 863-7825
Mailing address
1442 VALOTA RD, REDWOOD CITY, CA 94061-2620
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/08/2017
Last updated
02/08/2017
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