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Individual

EVELYN M JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
53 CALLE AKELIA, SAN CLEMENTE, CA 92673-7038
(949) 584-2985
Mailing address
53 CALLE AKELIA, SAN CLEMENTE, CA 92673-7038
(949) 584-2985

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
20A5663
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00AX56630
MEDI CAL
CA
Enumeration date
07/28/2006
Last updated
04/18/2025
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