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1750604583
JOHANNA CHRISTINE WALTHALL
COSTA MESA, CA
NPI
1750604583
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
103TC0700X Psychologist Clinical
(Licence: CA PSY21948)
Enumeration Date
2010-03-08
Last Update Date
2021-12-06
Business Address
JOHANNA CHRISTINE WALTHALL PH.D.
180 CABRILLO ST APT B19
COSTA MESA, CA 92627-3051
Phone number: 562-234-7568
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Mailing Address
JOHANNA CHRISTINE WALTHALL PH.D.
17046 MARYGOLD AVE
FONTANA, CA 92335-1722
Phone number: 909-427-6705
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