Individual
JENNY LYNNE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4650 W SUNSET BLVD # 54, LOS ANGELES, CA 90027-6062
(323) 361-8185
Mailing address
11929 VENICE BLVD APT 303, LOS ANGELES, CA 90066-3938
(248) 514-6032
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
95009984
CA
Other
Enumeration date
09/18/2018
Last updated
09/18/2018
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