Provider Demographics
NPI:1992387005
Name:JOHNSON, ARLENE
Entity Type:Individual
Prefix:
First Name:ARLENE
Middle Name:
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:PO BOX 12469
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93389-2469
Mailing Address - Country:US
Mailing Address - Phone:661-332-4234
Mailing Address - Fax:
Practice Address - Street 1:30 NIGHTINGALE ROAD BLDG 5513
Practice Address - Street 2:
Practice Address - City:EDWARDS AFB
Practice Address - State:CA
Practice Address - Zip Code:93524-0001
Practice Address - Country:US
Practice Address - Phone:661-277-5292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-27
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW808961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical