Individual
KRISTY LEE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
771 W BLAINE ST STE C, RIVERSIDE, CA 92507-3940
(951) 358-4120
Mailing address
771 W BLAINE ST STE C, RIVERSIDE, CA 92507-3940
(951) 358-4120
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
01/20/2022
Last updated
02/20/2024
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