Healthcare Provider Details

I. General information

NPI: 1093513616
Provider Name (Legal Business Name): ERIN NICOLE JOHNSON MA; PPSC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2025
Last Update Date: 03/07/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7997 VOMAC RD
DUBLIN CA
94568-1409
US

IV. Provider business mailing address

7997 VOMAC RD
DUBLIN CA
94568-1409
US

V. Phone/Fax

Practice location:
  • Phone: 925-833-1204
  • Fax:
Mailing address:
  • Phone: 925-833-1204
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number220212831
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: