Individual
AMANDA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
4601 DALE RD, MODESTO, CA 95356-9718
(209) 735-5086
Mailing address
1533 MARINO CT, MANTECA, CA 95337-9623
(209) 872-7172
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
01/31/2022
Last updated
01/31/2022
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