Provider Demographics
NPI:1063749182
Name:JOHNSTON, JONI ELIZABETH (PSYD)
Entity type:Individual
Prefix:DR
First Name:JONI
Middle Name:ELIZABETH
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:JONI
Other - Middle Name:ELIZABETH
Other - Last Name:JOHNSTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:1940 SEAVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92014-2228
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1940 SEAVIEW AVE
Practice Address - Street 2:
Practice Address - City:DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92014-2228
Practice Address - Country:US
Practice Address - Phone:858-583-3306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-10
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15692103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical