Individual provider Active NPI

Kasey Johnson

  • Marriage & Family Therapist
  • Santa Ana, CA
National Provider Identifier
1104615277
Registry record updated May 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
154929 Issued in CA
Practice address
1633 E 4TH St Ste 120
Santa Ana, CA 92701-5143
Phone
(714) 558-9266
NPI assigned
May 5, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 154929 CA Primary

Addresses

Primary practice location

1633 E 4TH St Ste 120
Santa Ana, CA 92701-5143

Mailing address

1633 E 4TH St Ste 120
Santa Ana, CA 92701-5143
Phone (714) 558-9266

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 30, 2025 through Apr 30, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
154929CAMDMarriage & Family Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1746403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746403200000",
    "number": "1104615277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1633 E 4TH ST STE 120",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927015143",
            "telephone_number": "714-558-9266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1633 E 4TH ST STE 120",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927015143",
            "telephone_number": "714-558-9266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KASEY",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-05",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "154929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.