Individual provider · Type 1 NPI

Jacqueline Johansen

Mental Health Counselor · Santa Rosa, CA

NPI number 1346501244 Active

Practice location

1160 N Dutton Ave, Suite 105
Santa Rosa, CA 95401-4600

Fax (707) 545-2774

Mailing address

2275 Arlington Dr
San Leandro, CA 94578-1132

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1346501244

Jacqueline Johansen's National Provider Identifier is 1346501244, issued on Jun 6, 2012. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Santa Rosa, CA. The record was last updated on Jun 6, 2012.