Individual
KATHLEEN GRUNBAUM JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
902 S MYRTLE AVE, MONROVIA, CA 91016-1765
(626) 357-3258
(626) 303-0529
Mailing address
902 S MYRTLE AVE, MONROVIA, CA 91016-3427
(626) 357-3258
(626) 303-0529
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT32661
CA
Other
Enumeration date
09/07/2017
Last updated
07/21/2022
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