Individual
AUDREY LYNN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RADT-1
Contact information
Practice address
4343 WILLIAMSBOURGH DR, SACRAMENTO, CA 95823-2006
(916) 714-5400
Mailing address
5010 LAGUNA PARK DR, ELK GROVE, CA 95758-5241
(916) 802-2629
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
CA
Other
Enumeration date
08/01/2018
Last updated
05/17/2021
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