Basic Information
| Provider Information | |||||||||
| NPI: | 1336465970 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JOHNSTON | ||||||||
| FirstName: | JULIE | ||||||||
| MiddleName: | ALANE | ||||||||
| NamePrefix: | MISS | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 8362 | ||||||||
| Address2: | |||||||||
| City: | BODFISH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 932058362 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7074940094 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2504 CALIFORNIA AVE | ||||||||
| Address2: | |||||||||
| City: | BAKERSFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 93304 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6613260485 | ||||||||
| FaxNumber: | 6613261455 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/07/2010 | ||||||||
| LastUpdateDate: | 04/07/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.