Individual
DR. JENNIFER JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9300 VALLEY CHILDRENS PL, MADERA, CA 93636-8761
(559) 353-5714
Mailing address
56 W SIENA LN, CLOVIS, CA 93619-2614
(559) 250-6853
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
A149107
CA
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
A149107
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A149107
CALIFORNIA MEDICAL LICENSE
CA
Enumeration date
03/28/2014
Last updated
07/09/2020
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