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Individual

KELLY ANN JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
A.T.C.

Contact information

Practice address
950 6TH AVE, 543, SAN DIEGO, CA 92101-6221
(619) 729-6498
Mailing address
PO BOX 501473, SAN DIEGO, CA 92150-1473
(619) 729-6498

Taxonomy

Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
BOC108324
CA

Other

Enumeration date
03/12/2013
Last updated
03/12/2013
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