Individual
CLANISHA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2008 N GAREY AVE, POMONA, CA 91767-2722
(909) 623-6131
(909) 865-9281
Mailing address
2008 N GAREY AVE, POMONA, CA 91767-2722
(909) 623-6131
(909) 865-9281
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-VCNQJL
CA
Other
Enumeration date
06/24/2025
Last updated
06/24/2025
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