Johansen, Jacqueline

Johansen, Jacqueline is an individual health care provider with primary practice located at 1160 N Dutton Ave Suite 105, Santa Rosa CA 95401-4600. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Johansen, Jacqueline can be contacted via phone (707) 545-2700.

Contact Information

Primary practice address
1160 N Dutton Ave Suite 105 Santa Rosa CA 95401-4600
Phone: (707) 545-2700
Fax: (707) 545-2774
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1346501244
LBN Legal business name Johansen, Jacqueline
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 6th, 2012
Last updated Jun 6th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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