Most Relevant Information
Provider Data
| NPI Number: | 1003645318 |
| Provider Name: | WENDY NORENE JOHNSON |
| Entity Type: | Individual |
| Taxonomy Code: | 2355S0801X |
| Specialty: | Specialist/Technologist |
| License Number: | 8845 |
Most Important Dates
| Enumeration Date: | 07/26/2024 |
| Last Updated: | 07/26/2024 |
Provider Practice Location
1968 W ADAMS BLVD STE 105
LOS ANGELES
CA
900183515
Practice Location Phone/Fax
| Phone: | 3105532695 |
| Fax: |
Provider Mailing Location
1968 W ADAMS BLVD STE 105
LOS ANGELES
CA
900183515
Provider Mailing Phone/Fax
| Phone: | 3105532695 |
| Fax: |