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NPI Code Detail

MEDICARE: KATHERINE JOAN JOHNSTON MCDONOUGH CCC-SLP

MEDICARE:   KATHERINE JOAN JOHNSTON MCDONOUGH  CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist24628CA

General Provider Information

NPI Number : 1689140006
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE JOAN JOHNSTON MCDONOUGH CCC-SLP
Provider Business Mailing Address
First Line : 1049 EL MONTE AVE STE C185
Second Line :
City : MOUNTAIN VIEW
State : CA
Zip : 94040-2398
Country : US
Telephone Number : 408-409-5161
Fax Number :
Provider Business Practice Location Address
First Line : 1049 EL MONTE AVE STE C185
Second Line :
City : MOUNTAIN VIEW
State : CA
Zip : 94040-2398
Country : US
Telephone Number : 408-409-5161
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2018
Last Update Date : 04/23/2021

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Directions to “ KATHERINE JOAN JOHNSTON MCDONOUGH CCC-SLP” Practice Location

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