Individual
CHANEL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9990 COUNTY FARM RD, SUITE 5, RIVERSIDE, CA 92503-3542
(951) 358-4834
Mailing address
9990 COUNTY FARM RD, SUITE 5, RIVERSIDE, CA 92503-3542
(951) 358-4834
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
04/23/2013
Last updated
04/23/2013
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