Individual
MS. IRENE JOHNSON- BULLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8867 BLUE RIVER DR, VALLEJO, CA 94591-8724
(510) 260-5481
Mailing address
8867 BLUE RIVER DR, VALLEJO, CA 94591-8724
(510) 260-5481
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
04/01/2020
Last updated
04/01/2020
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