AXELINE JANICKE MAISONET JOHNSON

RIVERSIDE, CA
NPI1649776899
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: CA  179054)
Additional Taxonomies2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: PA  MD470729)
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2018-04-04
Last Update Date2022-11-17
Business Address
AXELINE JANICKE MAISONET JOHNSON MD
4371 LATHAM ST STE 200
RIVERSIDE, CA 92501-1731
Phone number: 833-867-4642
Mailing Address
AXELINE JANICKE MAISONET JOHNSON MD
4371 LATHAM ST
RIVERSIDE, CA 92501-1706
Phone number: 833-867-4642