Individual
ELAINE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1735 ENTERPRISE DR, SUITE 105A, FAIRFIELD, CA 94533-6822
(707) 425-1799
Mailing address
810 HILLBORN CT, SUISUN CITY, CA 94585-4116
(707) 208-0815
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
01/28/2011
Last updated
01/28/2011
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