Individual
SUSAN RIDEOUT JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
54 WEST GRASS VALLEY STREET, COLFAX, CA 95713-9463
(916) 638-8758
Mailing address
PO BOX 1621, 54 W GRASS VALLEY ST, COLFAX, CA 95713-9463
(916) 638-8758
Taxonomy
Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
G59919
CA
Other
Enumeration date
05/09/2007
Last updated
08/23/2007
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