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General NPI Number Information
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NPI Number | 1154060986
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Entity Type | Individual
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Provider Name | SHARON JOHNSON
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Gender | Female
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Dates
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Enumeration Date | 05/31/2022
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Last Update Date | 05/31/2022
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Provider Practice Location Address
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Address Line | 2019 SATURN ST
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City | MONTEREY PARK
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State | CA
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Zip | 91755-7415
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Country | US
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Telephone | 323-724-0019
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Fax |
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Provider Business Mailing Address
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Address Line | 5982 FOREST GLEN DR
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City | FONTANA
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State | CA
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Zip | 92336-1069
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Country | US
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Telephone | 323-842-3280
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | VN278109
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License Number State | CA
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