Provider Demographics
NPI:1518239979
Name:JOHNSON, LYNDEE
Entity Type:Individual
Prefix:MS
First Name:LYNDEE
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5047 SANTA SUSANA AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93111-2141
Mailing Address - Country:US
Mailing Address - Phone:805-280-1789
Mailing Address - Fax:
Practice Address - Street 1:4129 STATE ST STE B
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93110-2853
Practice Address - Country:US
Practice Address - Phone:805-964-4795
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-01
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)