Provider Demographics
NPI:1821138777
Name:JOHNSON, CATHERINE A (MA, CCC)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:A
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MA, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31831 CAMINO CAPISTRANO
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAN JUAN CAPISTRANO
Mailing Address - State:CA
Mailing Address - Zip Code:92675-3211
Mailing Address - Country:US
Mailing Address - Phone:949-487-5251
Mailing Address - Fax:949-487-5242
Practice Address - Street 1:31831 CAMINO CAPISTRANO
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN JUAN CAPISTRANO
Practice Address - State:CA
Practice Address - Zip Code:92675-3211
Practice Address - Country:US
Practice Address - Phone:949-487-5251
Practice Address - Fax:949-487-5242
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP 8097235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist