Provider Demographics
NPI:1457351439
Name:ELOISE R. JOHNSTON & ASSOCIATES
Entity Type:Organization
Organization Name:ELOISE R. JOHNSTON & ASSOCIATES
Other - Org Name:LAURIE SILVERMAN & ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:MORNOUT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-451-2757
Mailing Address - Street 1:11770 BERNARDO PLAZA CT
Mailing Address - Street 2:SUITE 208
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-2422
Mailing Address - Country:US
Mailing Address - Phone:858-451-2757
Mailing Address - Fax:858-451-2790
Practice Address - Street 1:11770 BERNARDO PLAZA CT
Practice Address - Street 2:SUITE 208
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-2422
Practice Address - Country:US
Practice Address - Phone:858-451-2757
Practice Address - Fax:858-451-2790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP7056235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGSP000310Medicaid
CA=========OtherGROUP INSURANCE PROVIDER
CA056667Medicare ID - Type UnspecifiedPROVIDER NUMBER