Individual
TARA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
280 TELLER ST STE 120, CORONA, CA 92879-1888
(909) 825-7084
Mailing address
280 TELLER ST STE 120, CORONA, CA 92879-1888
(909) 825-7084
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
229904
CA
Other
Enumeration date
08/04/2026
Last updated
08/04/2026
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