Organization
DEBRA A. JOHNSON, PH.D., A PSYCHOLOGY CORPORATION
Active
Other names
Child Sexual Abuse Treatment Services
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEBRA A JOHNSON PH. D. (OWNER)
(209) 527-4682
Entity
Organization
Contact information
Practice address
610 14TH ST, MODESTO, CA 95354-2505
(209) 524-4858
(209) 524-7780
Mailing address
615 15TH ST, MODESTO, CA 95354-2510
(209) 527-4682
(209) 524-7780
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5027
—
CA
Enumeration date
03/01/2007
Last updated
02/07/2008
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