Individual
JACOB JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
225 37TH AVE, SAN MATEO, CA 94403-4324
(650) 573-2222
Mailing address
1048 CONTINENTALS WAY APT 36, BELMONT, CA 94002-3188
(503) 804-0815
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
A184926
CA
Other
Enumeration date
05/10/2021
Last updated
04/16/2023
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