Individual
KIMBERLY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
3989 W STETSON AVE STE 202, HEMET, CA 92545-9697
(951) 652-3558
(951) 652-5547
Mailing address
3660 PARK SIERRA DR STE 203, RIVERSIDE, CA 92505-3071
(951) 687-3400
(951) 687-7630
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95019553
CA
363LF0000X
Family Nurse Practitioner
95019553
CA
Other
Enumeration date
03/07/2022
Last updated
03/17/2022
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