Individual
BRANDON L JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
21041 PARTHENIA AVE, # 207, CANOGA, CA 91325
(562) 281-2463
Mailing address
21041 PARTHENIA ST, # 207, CANOGA PARK, CA 91304-2078
(562) 281-2463
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
453418895
CA
171W00000X
Contractor
Primary
453418895
CA
Other
Enumeration date
10/15/2011
Last updated
10/15/2011
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