Most Relevant Information
Provider Data
| NPI Number: | 1003335423 |
| Provider Name: | JESSICA MARIE JOHNSON AUD |
| Entity Type: | Individual |
| Taxonomy Code: | 231H00000X |
| Specialty: | Audiologist |
| License Number: | SLP-AU-LIC-6628 |
Most Important Dates
| Enumeration Date: | 09/18/2017 |
| Last Updated: | 07/30/2019 |
Provider Practice Location
5342 DUDLEY BLVD # 95652
MCCLELLAN
CA
956521012
Practice Location Phone/Fax
| Phone: | 9165617400 |
| Fax: |
Provider Mailing Location
5342 DUDLEY BLVD # 95652
MCCLELLAN
CA
956521012
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |