Individual
JILLIAN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
116 AGNES AVE, SANTA MARIA, CA 93458-2838
(805) 457-3724
Mailing address
733 N E ST APT F, LOMPOC, CA 93436-4534
(805) 298-7871
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-ZAMGNC
CA
373H00000X
Day Training/Habilitation Specialist
—
—
Other
Enumeration date
06/17/2024
Last updated
05/17/2025
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