Individual
CHARDA LYNN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B.A
Contact information
Practice address
3435 W SHAW AVE STE 101, FRESNO, CA 93711-3234
(559) 326-8283
Mailing address
3435 W SHAW AVE STE 101, FRESNO, CA 93711-3234
(559) 326-8283
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10AQ
—
CA
Enumeration date
04/26/2012
Last updated
04/26/2012
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