Individual
MRS. JENNIFER ANNE JOHNSTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5717 PACIFIC CENTER BLVD STE 200, SAN DIEGO, CA 92121-4250
(858) 859-1188
Mailing address
5717 PACIFIC CENTER BLVD STE 200, SAN DIEGO, CA 92121-4250
(858) 859-1188
(480) 512-5486
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA55545
CA
363AS0400X
Surgical Physician Assistant
2492
AZ
Other
Enumeration date
01/16/2008
Last updated
05/06/2019
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