Individual
AARON JOSEPH JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BA
Contact information
Practice address
1420 IOWA AVE STE 3, RIVERSIDE, CA 92507-0509
(909) 266-2792
Mailing address
325 W HOSPITALITY LN STE 103, SAN BERNARDINO, CA 92408-3210
(951) 278-8058
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
225800000X
Recreation Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
225800000X
MEDI-CAL
CA
Enumeration date
02/10/2010
Last updated
03/17/2018
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