Individual
MRS. AUTUMN LAUREN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPAP, PA-C
Contact information
Practice address
2650 S BRISTOL ST STE 101, SANTA ANA, CA 92704-5751
(714) 754-1444
Mailing address
360 GIOTTO, IRVINE, CA 92614-8581
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
CA
Other
Enumeration date
06/12/2017
Last updated
06/12/2017
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