Matthew Daniel Johnson, B.A.
Rehabilitation Practitioner in Pasadena, CA. Individual provider (NPI-1).
NPI number1679856413
StatusActive
Last updated in NPPESJul 24, 2013
Details
- NPI
- 1679856413
- Entity type
- Individual (NPI-1)
- Name
- Mr. Matthew Daniel Johnson
- Credential
- B.A.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Sep 27, 2011
- Last updated
- Jul 24, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225400000X | Rehabilitation Practitioner | – | CA | Yes |
Other names
- Matthew Daniel Johnson (Former Name)
Practice location
940 Avenue 64Pasadena, CA 91105
Phone 323-254-2274 · Fax 323-254-9087
Mailing address
940 Avenue 64Pasadena, CA 91105
Phone 323-254-2274 · Fax 323-254-9087
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