Individual
CHARLOTTE SIONGCO JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
20996 BAKE PKWY STE 106, LAKE FOREST, CA 92630-2169
(949) 600-5437
Mailing address
20996 BAKE PKWY STE 106, LAKE FOREST, CA 92630-2169
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT7072
CA
Other
Enumeration date
04/23/2013
Last updated
04/25/2014
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