Individual
TRACY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8200 HAVEN AVE APT 7211, RANCHO CUCAMONGA, CA 91730-6972
(951) 427-4424
Mailing address
16250 HOMECOMING DR UNIT 1485, CHINO, CA 91708-8858
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106E00000X
Assistant Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
01/25/2018
Last updated
02/03/2020
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