Individual
JOHAN PAULINE ROBERTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
2307 W 6TH ST, LOS ANGELES, CA 90057-3119
(213) 351-2800
Mailing address
9664 RUSHMORE ST, PICO RIVERA, CA 90660-3653
(408) 420-1126
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
701641
CA
Other
Enumeration date
01/24/2020
Last updated
01/24/2020
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