Individual
DEANTE M JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3532 ALAMEDA DE LAS PULGAS, MENLO PARK, CA 94025-6510
(650) 561-9589
Mailing address
900 PALM AVE APT 9, SAN MATEO, CA 94401-4256
(650) 270-0833
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
49202
CA
Other
Enumeration date
03/01/2018
Last updated
03/01/2018
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