Individual
COULSANDER JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2090 MYRTLE AVE, LONG BEACH, CA 90806-4932
(562) 230-3354
(562) 247-1822
Mailing address
2090 MYRTLE AVE, LONG BEACH, CA 90806-4932
(562) 230-3354
(562) 247-1822
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN192615
CA
251E00000X
Home Health Agency
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
05/19/2015
Last updated
12/31/2019
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