Individual
CORNELL JOHNSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3700 HILBORN RD STE 950, FAIRFIELD, CA 94534-7999
(707) 639-1138
Mailing address
3700 HILBORN RD STE 950, FAIRFIELD, CA 94534-7999
(707) 639-1138
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/13/2024
Last updated
06/13/2024
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