Individual
JACQUELINE ROSE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3020 CHILDRENS WAY # MC5068, SAN DIEGO, CA 92123-4223
(303) 720-5037
Mailing address
3020 CHILDRENS WAY # MC5068, SAN DIEGO, CA 92123-4223
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
23621
CA
Other
Enumeration date
12/22/2023
Last updated
12/22/2023
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