Individual
DAMARIA ANTIONETTE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1215 ARMORLITE DR APT 120, SAN MARCOS, CA 92069-1397
(213) 910-9174
Mailing address
960 POSTAL WAY # 1690, VISTA, CA 92083-6915
(213) 910-9174
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
F4286983
CA
Other
Enumeration date
08/03/2020
Last updated
08/03/2020
About Stedi
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