Individual
DR. KRISTINE M JOHNSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
130 LEWIS STREET, SAN ANTONIO, TX 78212-5538
(210) 829-7471
(210) 829-5398
Mailing address
130 LEWIS STREET, SAN ANTONIO, TX 78212-5538
(210) 829-7471
(210) 829-5398
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
228590
TX
103TF0200X
Forensic Psychologist
228590
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00F79C
MEDICARE
TX
05
—
0332306-01
—
TX
01
—
TXB154952
MEDICARE
TX
Enumeration date
12/12/2006
Last updated
10/01/2019
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