Individual
CRYSTAL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, PMHNP-BC
Contact information
Practice address
17612 17TH ST STE A, TUSTIN, CA 92780-1962
(800) 383-8180
Mailing address
17612 17TH ST STE A, TUSTIN, CA 92780-1962
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
274396
TN
163W00000X
Registered Nurse
95364126
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95031925
CA
Other
Enumeration date
08/28/2024
Last updated
11/20/2024
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