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1750813077
LAURA REBECCA PENDERGAST JOHNSON
SAN DIEGO, CA
NPI
1750813077
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: 17249)
Enumeration Date
2017-03-28
Last Update Date
2021-11-16
Business Address
LAURA REBECCA PENDERGAST JOHNSON OTR/L
1809 NATIONAL AVE
SAN DIEGO, CA 92113-2113
Phone number: 619-515-2300
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Mailing Address
LAURA REBECCA PENDERGAST JOHNSON OTR/L
823 GATEWAY CENTER WAY
SAN DIEGO, CA 92102-4541
Phone number:
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