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Waverly Johnson
NPI 1639415235 · on the registry since 2012 · sole proprietor
Practice
- Address
- 1726 E. 117th St.
Los Angeles, CA 90059 - Phone
- (323) 566-1965
- Organisation at this address
- Barack Obama Charter School
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- Health Educator
174H00000X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2012-12-31
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