Organization
LEMON HEIGHTS HOLDINGS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT NILS JOHANSEN PH.D. (OWNER-OFFICER)
(562) 860-2210
Entity
Organization
Contact information
Practice address
17215 STUDEBAKER ROAD, SUITE 110, CERRITOS, CA 90703-2521
(562) 860-2210
(562) 860-1154
Mailing address
PO BOX 2089, ARTESIA, CA 90702-2089
(562) 860-2210
(714) 940-0941
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY10129
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PSY101290
—
CA
Enumeration date
03/06/2013
Last updated
03/06/2013
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