Jacqueline Marie Johnson

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

AMFT139657 Issued in CA

Practice address

1925 Euclid Ave Ste 108
San Diego, CA 92105-5362

Phone

(619) 648-1158

NPI assigned

Sep 18, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1694995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1295513638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 21ST ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921022814",
            "telephone_number": "858-245-3045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 EUCLID AVE STE 108",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921055362",
            "telephone_number": "619-648-1158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JACQUELINE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-18",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "AMFT139657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory D Johnson
• Haley Paige Johnson
• Heather Johnson, PH.D., M.A., M.S.
• Heather Lian Johnson
• Horace Johnson, RN
• Jacqueline Rose Johnson
• Jaelyn Johnson, MPH
• Jaimee Janai Johnson
• James L. Johnson, M.D.
• Jammi Johnson

• Mental Health Counselor in San Diego, CA
• Providers in San Diego, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.