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Individual

MR. RUDOLPH JOHNSON JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CATC1

Contact information

Practice address
6537 REFLECTION DR APT 105, SAN DIEGO, CA 92124-3111
(619) 727-7797
Mailing address
6537 REFLECTION DR APT 105, SAN DIEGO, CA 92124-3111
(619) 727-7797

Taxonomy

Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
CA

Other

Enumeration date
10/20/2016
Last updated
10/20/2016
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