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General NPI Number Information
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NPI Number | 1891748992
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Entity Type | Individual
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Provider Name | LESLIE MARTIN JOHNSON JR. PSYD
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Gender | Male
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 03/29/2014
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Provider Practice Location Address
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Address Line | 1001 BISHOP STREET SUITE 2870
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City | HONOLULU
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State | HI
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Zip | 96813-3482
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Country | US
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Telephone | 808-538-7793
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Fax | 808-538-7799
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Provider Business Mailing Address
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Address Line | 1001 BISHOP STREET SUITE 2870
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City | HONOLULU
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State | HI
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Zip | 96813-3482
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Country | US
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Telephone | 808-538-7793
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Fax | 808-538-7799
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY 736
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License Number State | HI
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