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Individual

NICOLE MARIE JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
7676 HAZARD CENTER DR STE 500, SAN DIEGO, CA 92108-4508
(800) 585-1299
Mailing address
579 RIVERSIDE PARK RD, CARLOTTA, CA 95528-9644

Taxonomy

Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
23462
CA

Other

Enumeration date
05/24/2023
Last updated
05/24/2023
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