Active NPI
Carrie Lynne Johnson, MFT
- Marriage & Family Therapist
- San Francisco, CA
National Provider Identifier
1245518943
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 79984
- Practice address
- 2224A Bush St
San Francisco, CA 94115-3122 - Phone
- (415) 894-2766
- NPI assigned
- Jul 28, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 79984 | CA | Primary |
Addresses
Primary practice location
2224A Bush St
San Francisco, CA 94115-3122
Mailing address
3001 Broderick St Apt 4
San Francisco, CA 94123-3238
Phone (630) 388-8845
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 79984 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1245518943",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3001 BRODERICK ST APT 4",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941233238",
"telephone_number": "630-388-8845"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2224A BUSH ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941153122",
"telephone_number": "415-894-2766"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "CARRIE",
"middle_name": "LYNNE",
"credential": "MFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-07-28",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "79984",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.