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1699390989
JEROME A JOHNSON
MODESTO, CA
NPI
1699390989
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2020-06-11
Last Update Date
2020-06-11
Business Address
JEROME A JOHNSON
100 POPLAR AVE
MODESTO, CA 95354-0510
Phone number: 209-324-2589
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Mailing Address
JEROME A JOHNSON
100 POPLAR AVE
MODESTO, CA 95354-0510
Phone number: 209-324-2589
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