Type 1 individualNPI 1003538398
JACQUELINE JOHNSON
104100000X · LONG BEACH, CA
Why this profile is appearing now
Observed change signals
No current public change signal is attached to this profile.
Reported classification
Taxonomies
| Code | Description | Source flag |
|---|---|---|
| 104100000X | 104100000X | Primary |
| 1041C0700X | 1041C0700X | Additional |
Taxonomy reporting does not establish licensure, board certification, expertise, or quality.
Longitudinal record
Observed change timeline
- 0 recorded field change s