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Individual

DIANE MAE JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
SUD

Contact information

Practice address
455 K ST, CRESCENT CITY, CA 95531-4107
(707) 464-7224
Mailing address
1345 E MADISON AVE SPC 24, EL CAJON, CA 92021-8535
(619) 753-0850

Taxonomy

Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary

Other

Enumeration date
06/26/2020
Last updated
07/18/2025
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