Individual
BENNADINE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYCHOLOGICAL ASSIST
Contact information
Practice address
1501 5TH AVE STE 100, SAN DIEGO, CA 92101-3251
(619) 461-3717
(619) 456-0832
Mailing address
1501 5TH AVE STE 100, SAN DIEGO, CA 92101-3251
(619) 461-3717
(619) 456-0832
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSB94022308
CA
Other
Enumeration date
03/16/2016
Last updated
03/16/2016
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