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NPI Code Detail

MEDICARE: LISA MICHELLE JOHNSTON CAS# 8492

MEDICARE: LISA MICHELLE JOHNSTON CAS# 8492
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorCAS #8492CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1A4293520OTHERCADMV

General Provider Information

NPI Number : 1881836302
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA MICHELLE JOHNSTON CAS# 8492
Provider Business Mailing Address
First Line : 2931 PROSPECT AVE
Second Line :
City : CONCORD
State : CA
Zip : 94518-1025
Country : US
Telephone Number : 925-676-4840
Fax Number : 925-676-1315
Provider Business Practice Location Address
First Line : 2931 PROSPECT AVE
Second Line :
City : CONCORD
State : CA
Zip : 94518-1025
Country : US
Telephone Number : 925-676-4840
Fax Number : 925-676-1315
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2009
Last Update Date : 03/30/2009

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Directions to “ LISA MICHELLE JOHNSTON CAS# 8492” Practice Location

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