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Individual

GESSICA JOHNSTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
500 AIRPORT BLVD STE 100, BURLINGAME, CA 94010-1980
(415) 652-3581
Mailing address
896 TERRA CALIFORNIA DR, #3, WALNUT CREEK, CA 94595-3086
(925) 287-8087
(925) 287-1797

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
G22811
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
19812
LICENSE
AZ
01
G22811
LICENSE
CA
Enumeration date
05/10/2007
Last updated
07/08/2007
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