Healthcare Provider Details

I. General information

NPI: 1851904197
Provider Name (Legal Business Name): ALBERT JOHNS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2020
Last Update Date: 08/26/2020
Certification Date: 08/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 11TH ST NW APT 501
WASHINGTON DC
20001-2223
US

IV. Provider business mailing address

50 STONEGATE DR
SILVER SPRING MD
20905-5701
US

V. Phone/Fax

Practice location:
  • Phone: 240-342-9100
  • Fax: 202-450-1813
Mailing address:
  • Phone: 240-342-9100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: