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Individual

MARCELLINA JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
550 S VERMONT AVE, LOS ANGELES, CA 90020-1912
(800) 854-7771
Mailing address
525 E SEASIDE WAY UNIT 309, LONG BEACH, CA 90802-8002
(626) 221-7401

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
457076
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
182456
CA

Other

Enumeration date
12/27/2010
Last updated
12/02/2021
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