Individual provider Active NPI

Jennifer Dolores Johnson, LMFT

  • Marriage & Family Therapist
  • Westminster, CA
National Provider Identifier
1306130257
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
113854 Issued in CA
Practice address
5455 Garden Grove Blvd Ste 200
Westminster, CA 92683-8201
Phone
(562) 431-8822
NPI assigned
Jun 7, 2011
Last updated
Aug 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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 113854 CA Primary

Addresses

Primary practice location

5455 Garden Grove Blvd Ste 200
Westminster, CA 92683-8201

Mailing address

5455 Garden Grove Blvd Ste 200
Westminster, CA 92683-8201

Other practice location 1

505 N. Euclid St.
Suite 300
Anaheim, CA 92801
Phone (714) 871-5646 ext. 4226

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240903003869 CA Practitioner - Marriage and Family Therapist 2264971332 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cyti Health PC CurrentSince Sep 28, 2024 Accepting new patients
Western Youth Services Past Accepting new patients

Locations

11801 Pierce St
Riverside, CA 92505
Phone (909) 528-0317

3111 Camino del Rio N
Ste 460
San Diego, CA 92108

402 W Broadway
Ste 400
San Diego, CA 92101
Phone (619) 810-1939

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1307404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1306130257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5455 GARDEN GROVE BLVD STE 200",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926838201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5455 GARDEN GROVE BLVD STE 200",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926838201",
            "telephone_number": "562-431-8822"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "505 N. Euclid St.",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "92801",
            "country_code": "US",
            "telephone_number": "714-871-5646 x4226",
            "fax_number": "714-817-7368",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JENNIFER",
        "middle_name": "DOLORES",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-07",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "113854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, CA

Sources for this page

Verify at the official NPI Registry.