Provider Demographics
NPI:1750729968
Name:JOHNSON, TERRIE (DVM)
Entity type:Individual
Prefix:DR
First Name:TERRIE
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20930 VICTORY BLVD
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-2609
Mailing Address - Country:US
Mailing Address - Phone:818-710-8528
Mailing Address - Fax:818-710-9312
Practice Address - Street 1:20930 VICTORY BLVD
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-2609
Practice Address - Country:US
Practice Address - Phone:818-710-8528
Practice Address - Fax:818-710-9312
Is Sole Proprietor?:No
Enumeration Date:2013-06-10
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12483174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian