Provider Demographics
NPI:1891449419
Name:JOHNSTONE, SANDRA (SLP-A)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:JOHNSTONE
Suffix:
Gender:F
Credentials:SLP-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5290 S MONTECITO DR
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94521-5502
Mailing Address - Country:US
Mailing Address - Phone:949-212-3268
Mailing Address - Fax:
Practice Address - Street 1:5290 S MONTECITO DR
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94521-5502
Practice Address - Country:US
Practice Address - Phone:949-212-3268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-11
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2016812355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant