Individual
LISA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CGC
Contact information
Practice address
201 INDUSTRIAL RD, SAN CARLOS, CA 94070-2396
(650) 249-9090
(650) 412-2305
Mailing address
1174 LANCASHIRE DR, XENIA, OH 45385-2582
(937) 681-3212
Taxonomy
Speciality
Code
Description
License number
State
170300000X
Genetic Counselor (M.S.)
Primary
70.000012
OH
170300000X
Genetic Counselor (M.S.)
GC001052
CA
Other
Enumeration date
08/14/2014
Last updated
10/19/2021
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