Healthcare Provider Details

I. General information

NPI: 1942601349
Provider Name (Legal Business Name): JOHANNA ALSAYYID
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2014
Last Update Date: 05/03/2026
Certification Date: 05/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

599 W 9TH ST
SAN PEDRO CA
90731-3105
US

IV. Provider business mailing address

100 VALLEY VIEW LN
JACKSONVILLE TX
75766-5853
US

V. Phone/Fax

Practice location:
  • Phone: 424-772-8044
  • Fax:
Mailing address:
  • Phone: 424-772-8044
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246RM2200X
TaxonomyMedical Laboratory Technician
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code246QM0706X
TaxonomyMedical Technologist
License Number
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: