Individual
JESSICA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1691 JOE SILVA AVE, ATWATER, CA 95301-9114
(209) 430-1688
Mailing address
1691 JOE SILVA AVE, ATWATER, CA 95301-9114
(209) 430-1688
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
B7586013
CA
Other
Enumeration date
10/22/2021
Last updated
10/22/2021
About Stedi
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