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1063957009
JACQUELINE JOHNSON
WEST COVINA, CA
NPI
1063957009
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: CA 95005643)
Enumeration Date
2016-12-29
Last Update Date
2017-01-12
Business Address
-- JACQUELINE JOHNSON
420 S. GLENDORA AVE
WEST COVINA, CA 91790
Phone number: 616-250-5247
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Mailing Address
-- JACQUELINE JOHNSON
420 S. GLENDORA AVE
WEST COVINA, CA 91790
Phone number:
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