Individual
PRINCESS JOHNSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
407 MAPLE ST, GALT, CA 95632-2048
(916) 821-2391
(209) 912-4141
Mailing address
407 MAPLE ST, GALT, CA 95632-2048
(916) 821-2391
(209) 912-4141
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
347005264
CA
376K00000X
Nurse's Aide
00648092
CA
Other
Enumeration date
10/04/2014
Last updated
10/04/2014
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