Individual
ALYSSA VIRGINIA JOHNSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1814 CIRBY WAY APT B, ROSEVILLE, CA 95661-5564
(770) 876-9602
Mailing address
1814 CIRBY WAY APT B, ROSEVILLE, CA 95661-5564
(770) 876-9602
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
95013336
CA
363LF0000X
Family Nurse Practitioner
Primary
95013336
CA
Other
Enumeration date
07/06/2018
Last updated
04/11/2022
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