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General NPI Number Information
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NPI Number | 1144117912
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Entity Type | Individual
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Provider Name | MRS. JAYME NOEL JOHNSON
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Gender | Female
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Dates
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Enumeration Date | 06/23/2025
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Last Update Date | 06/23/2025
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Provider Practice Location Address
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Address Line | 60A VESPIA LN
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City | WAKEFIELD
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State | RI
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Zip | 02879-8139
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Country | US
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Telephone | 757-348-7880
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Fax |
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Provider Business Mailing Address
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Address Line | 3250 BARNETT AVE APT 3168
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City | SAN DIEGO
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State | CA
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Zip | 92110-4249
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MHC00336A
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License Number State | RI
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