Individual
LAURALIE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
710 S CENTRAL AVE STE 100, GLENDALE, CA 91204-4613
(818) 660-4490
Mailing address
1107 FAIR OAKS AVE # 299, SOUTH PASADENA, CA 91030-3311
(858) 525-1575
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
95007354
CA
Other
Enumeration date
09/09/2017
Last updated
09/09/2017
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