Individual
JESSICA MARIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
5342 DUDLEY BLVD # 95652, MCCLELLAN, CA 95652-1012
(916) 561-7400
Mailing address
5342 DUDLEY BLVD # 95652, MCCLELLAN, CA 95652-1012
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
SLP-AU-LIC-6628
MT
Other
Enumeration date
09/18/2017
Last updated
07/30/2019
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