Active NPI
Zakiya Marie Johnson
- Marriage & Family Therapist
- Ontario, CA
National Provider Identifier
1104225747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 110743
- Practice address
- 855 N Euclid Ave
Ontario, CA 91762-2729 - Phone
- (909) 983-2020
- Fax
- (909) 983-6847
- NPI assigned
- Aug 20, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 84248 | CA | |
| Marriage & Family Therapist | 106H00000X | 110743 | CA | Primary |
Addresses
Primary practice location
855 N Euclid Ave
Ontario, CA 91762-2729
Mailing address
855 N Euclid Ave
Ontario, CA 91762-2729
Phone (909) 983-2020
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 951946482 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 110743 | CA | MD | Clinical Social Worker |
| 84248 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408492800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548806400000",
"number": "1104225747",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "855 N EUCLID AVE",
"city": "ONTARIO",
"state": "CA",
"postal_code": "917622729",
"telephone_number": "909-983-2020",
"fax_number": "909-983-6847"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "855 N EUCLID AVE",
"city": "ONTARIO",
"state": "CA",
"postal_code": "917622729",
"telephone_number": "909-983-2020",
"fax_number": "909-983-6847"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "ZAKIYA",
"middle_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-20",
"last_updated": "2019-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "84248",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "110743",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "951946482",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ontario, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.