Provider Demographics
NPI:1891919643
Name:JOHNSON, ZONYA COMELIA
Entity Type:Individual
Prefix:DR
First Name:ZONYA
Middle Name:COMELIA
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 1:39 BATES BLVD
Mailing Address - Street 2:
Mailing Address - City:ORINDA
Mailing Address - State:CA
Mailing Address - Zip Code:94563-2814
Mailing Address - Country:US
Mailing Address - Phone:925-254-2027
Mailing Address - Fax:
Practice Address - Street 1:5835 COLLEGE AVE
Practice Address - Street 2:STE B3
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94618-1653
Practice Address - Country:US
Practice Address - Phone:925-254-2027
Practice Address - Fax:925-254-2027
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY7119103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical