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Individual

LAURA DENISE JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, RD

Contact information

Practice address
1700 MCHENRY VILLAGE WAY, MODESTO, CA 95350-4308
(209) 548-7865
Mailing address
600 COFFEE RD, MODESTO, CA 95355-4201
(209) 521-6097

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
832914
CA

Other

Enumeration date
02/05/2016
Last updated
02/05/2016
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