Individual
PENELOPE ROSE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
988 MCCOURTNEY RD, GRASS VALLEY, CA 95949-7400
(530) 265-1437
Mailing address
500 CROWN POINT CIR STE 120, GRASS VALLEY, CA 95945-9561
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
08/20/2024
Last updated
04/01/2025
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