Healthcare Provider Details

I. General information

NPI: 1922570175
Provider Name (Legal Business Name): BRITNAE TERMARA JOHNSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2018
Last Update Date: 12/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

282 HERON DR
PITTSBURG CA
94565-1908
US

IV. Provider business mailing address

5820 STONERIDGE MALL RD STE 205
PLEASANTON CA
94588-3347
US

V. Phone/Fax

Practice location:
  • Phone: 925-238-6482
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: