Individual
AXELINE JANICKE MAISONET JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4371 LATHAM ST STE 200, RIVERSIDE, CA 92501-1731
(833) 867-4642
Mailing address
415 N CAMDEN DRIVE, STE 111 #724, BEVERLY HILLS, CA 90210
(833) 867-4642
(267) 367-5763
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
A179054
CA
2084P0800X
Psychiatry Physician
MD470729
PA
2084P0800X
Psychiatry Physician
W2736
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/04/2018
Last updated
12/29/2025
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