NPI 1164826400

Deantwann Johnson

Practitioner Community Health Worker Upland, CA

Practice location

Address: 1126 W Foothill Blvd Suite 150, Upland, CA 91786-3768
Phone: (909) 982-8641
Mailing address: 1170 N San Antonio Ave, Pomona, CA 91767-4104

Registered specialties

Community Health Worker Primary

Other Service Providers Taxonomy 172V00000X

Other Community Health Worker providers in California →

Registry record

NPI: 1164826400
Entity type: Individual
Sex (as registered): Male
NPI issued: 15 Oct 2014
Record last updated: 15 Oct 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.