Individual
YAXCHILAN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2208 SAN LEANDRO BLVD, SAN LEANDRO, CA 94577-5957
(510) 483-6715
Mailing address
2208 SAN LEANDRO BLVD, SAN LEANDRO, CA 94577-5957
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
09/22/2009
Last updated
09/22/2009
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