Provider Demographics
NPI:1770502890
Name:JOHNSON, ARLENE LEDESMA (DC)
Entity Type:Individual
Prefix:DR
First Name:ARLENE
Middle Name:LEDESMA
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 N LA CIENEGA BLVD
Mailing Address - Street 2:SUITE 9
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90048-2007
Mailing Address - Country:US
Mailing Address - Phone:310-855-7575
Mailing Address - Fax:310-360-1356
Practice Address - Street 1:519 N LA CIENEGA BLVD
Practice Address - Street 2:SUITE 9
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90048-2007
Practice Address - Country:US
Practice Address - Phone:310-855-7575
Practice Address - Fax:310-360-1356
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27473111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor