Individual
ALTIA N JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R. N.
Contact information
Practice address
260 E 15TH STREET, MERCED, CA 95341
(209) 381-1110
(209) 381-1102
Mailing address
260 E 15TH ST, MERCED, CA 95341-6216
(209) 381-1110
(209) 381-1102
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
425172
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
946000521
—
CA
Enumeration date
07/07/2011
Last updated
07/07/2011
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