Individual
ALTAY NIKKISHA JONES JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
3055 IRIS AVE UNIT D, SAN YSIDRO, CA 92173-1146
(619) 794-6362
Mailing address
3055 IRIS AVE UNIT D, SAN YSIDRO, CA 92173-1146
(619) 794-6362
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
260204
CA
Other
Enumeration date
07/24/2013
Last updated
07/24/2013
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