Individual
DEANNA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
902 S MYRTLE AVE, MONROVIA, CA 91016-3427
(626) 357-3258
Mailing address
814 W 61ST ST, LOS ANGELES, CA 90044-5402
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VM 247480
CA
Other
Enumeration date
07/10/2010
Last updated
07/10/2010
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