Search › California › 104100000X
Nicholette Johnson
NPI 1053960245 · on the registry since 2019 · sole proprietor
Practice
- Address
- 670 W Baseline Rd
San Dimas, CA 91773 - Phone
- (909) 741-7124
- Organisation at this address
- Heritage Group Homes Inc.
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 4
Additional practice sites
- 1940 Baseline Rd, La Verne, CA
- 3340 E Whitebirch Dr, West Covina, CA
- 8814 Santa Fe Springs Rd, Whittier, CA
- 1923 E Eckerman Ave, West Covina, CA
- 16226 E Benwick St., Valinda, CA
- 30 Country Wood Dr, Pomona, CA
- 158 Gentry St, Pomona, CA
Registry record
- Primary taxonomy
- 104100000X
104100000X
- Also registered as
- 101YM0800X
1041C0700X - Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2023-05-30
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California