Individual
JADE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
313 W 31ST ST, SAN PEDRO, CA 90731-6783
(310) 415-0285
Mailing address
313 W 31ST ST, SAN PEDRO, CA 90731-6783
(310) 415-0285
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
95401641
CA
Other
Enumeration date
10/01/2025
Last updated
10/01/2025
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