Individual
CHARISMA SHAUNTAE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
601 W 3RD ST, IMPERIAL, CA 92251-1404
(424) 207-7947
Mailing address
601 W 3RD ST, IMPERIAL, CA 92251-1404
(424) 207-7947
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
231556
CA
Other
Enumeration date
12/07/2020
Last updated
12/07/2020
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