Provider Demographics
NPI:1144369901
Name:JOHNS, ROSALINA (CAADAC)
Entity type:Individual
Prefix:MS
First Name:ROSALINA
Middle Name:
Last Name:JOHNS
Suffix:
Gender:F
Credentials:CAADAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13801 VAN NESS AVE
Mailing Address - Street 2:APT. # 2
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90249-2446
Mailing Address - Country:US
Mailing Address - Phone:310-538-3039
Mailing Address - Fax:310-515-8044
Practice Address - Street 1:2500 WILSHIRE BLVD
Practice Address - Street 2:SUITE # 500
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-4303
Practice Address - Country:US
Practice Address - Phone:213-639-0208
Practice Address - Fax:213-388-1491
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health