Provider Demographics
NPI:1760003149
Name:JOHNSTON, DANIELLE CHRISTINE (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:CHRISTINE
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1280 S BARRINGTON AVE APT 14
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-1642
Mailing Address - Country:US
Mailing Address - Phone:734-474-0399
Mailing Address - Fax:
Practice Address - Street 1:1280 S BARRINGTON AVE APT 14
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-1642
Practice Address - Country:US
Practice Address - Phone:734-474-0399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-27
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34288111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor