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General NPI Number Information
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NPI Number | 1467576751
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Entity Type | Individual
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Provider Name | ALEXIS JOHNS PH.D.
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Gender | Female
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 06/19/2014
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Provider Practice Location Address
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Address Line | 4650 W SUNSET BLVD MS#96
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City | LOS ANGELES
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State | CA
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Zip | 90027-6062
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Country | US
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Telephone | 323-669-7060
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Fax |
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Provider Business Mailing Address
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Address Line | 757 N CROFT AVE
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City | LOS ANGELES
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State | CA
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Zip | 90069-5303
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 20686
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License Number State | CA
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