Heather Jean Johnson, M.A., MFT, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY25944 Issued in CA

Practice address

101 S Kraemer Blvd
Ste 114
Placentia, CA 92870-6109

Phone

(714) 253-4104

NPI assigned

Mar 15, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Heather Jean Gumm Former name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cognitive Care Solutions Group Inc

  • Cognitive & Behavioral Psychologist
  • Santa Ana, CA
  • NPI 1548614183
  Medicare reassignment NPD
• Enki Health Services, Inc.

  • Community/Behavioral Health Agency
  • Los Angeles, CA
  • NPI 1932230638
  Medicare reassignment NPD
• Enki Health Services, Inc.

  • Community/Behavioral Health Agency
  • Commerce, CA
  • NPI 1366574188
  NPD

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572912000000",
    "number": "1174657902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17121 BLACK WALNUT CT",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928866237",
            "telephone_number": "714-812-4991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S KRAEMER BLVD",
            "address_2": "STE 114",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928706109",
            "telephone_number": "714-253-4104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "HEATHER",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "M.A., MFT, PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2019-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC29054",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY25944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "GUMM",
            "middle_name": "JEAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Emily Jewell
• James Evaristo Jimenez
• John S. Marshburn, M.D., Inc
• Jaya John
• Heather Ellen Johnson, O.T.
• Jesselyn Johnson, RN
• Jaden August Jones
• Jorge de la Osa Dental Corporation
• Jose Eduardo Lara DDS Inc
• Joseph G Mayo III MD Inc

• Psychologist in Placentia, CA
• Providers in Placentia, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.