Provider Demographics
NPI:1942767082
Name:JOHNSON, ENJOLII YEMON
Entity Type:Individual
Prefix:
First Name:ENJOLII
Middle Name:YEMON
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 1:399 DRAKE AVE
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-7504
Mailing Address - Country:US
Mailing Address - Phone:831-643-9069
Mailing Address - Fax:831-655-3210
Practice Address - Street 1:399 DRAKE AVE
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-7504
Practice Address - Country:US
Practice Address - Phone:831-643-9069
Practice Address - Fax:831-655-3210
Is Sole Proprietor?:No
Enumeration Date:2019-02-25
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health