Individual
TIYA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
1400 E COOLEY DR # 200A, COLTON, CA 92324-3939
(909) 295-5295
Mailing address
PO BOX 741129, SAN DIEGO, CA 92174-1129
(619) 718-0362
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP2500X
Professional Counselor
Primary
18506
CA
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
02/15/2022
Last updated
01/31/2025
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