Octavia S Johnson

NPI #1104185529 in Colton, California

Provider Information

NPI Number: 1104185529
Entity Type: Individual
Name: Octavia S Johnson
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor - Mental Health
Enumeration Date: May 4, 2012
Last Updated: May 4, 2012

Practice Location

Address: 790 VIA LATA STE 300
City: Colton
State: California
ZIP Code: 92324-3978
Phone: (909) 433-0445

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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