Individual
AMY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16500 VENTURA BLVD, STE. 414, ENCINO, CA 91436-2011
(818) 788-1003
(818) 788-1135
Mailing address
16500 VENTUA BLVD.,, STE. 414, ENCINO, CA 91436-5050
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP10583
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SP 10583
SPEECH PATHOLOGY
CA
Enumeration date
03/29/2013
Last updated
03/29/2013
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