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1760857502
JERRY JOHNSON
PASADENA, CA
NPI
1760857502
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2015-12-04
Last Update Date
2015-12-04
Business Address
-- JERRY JOHNSON
1680 N FAIR OAKS AVE
PASADENA, CA 91103-1642
Phone number: 626-798-0884
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Mailing Address
-- JERRY JOHNSON
1680 N FAIR OAKS AVE
PASADENA, CA 91103-1642
Phone number: 626-798-0884
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