Deantwann Johnson

NPI #1164826400 in Upland, California

Provider Information

NPI Number: 1164826400
Entity Type: Individual
Name: Deantwann Johnson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Community Health Worker
Enumeration Date: Oct 15, 2014
Last Updated: Oct 15, 2014

Practice Location

Address: 1126 W FOOTHILL BLVD
Address 2: SUITE 150
City: Upland
State: California
ZIP Code: 91786-3768
Phone: (909) 982-8641

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Health Worker	172V00000X	Primary

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