Individual provider Active NPI

Matthew James Johnson, LMFT

  • Marriage & Family Therapist
  • Vallecito, CA
National Provider Identifier
1548577869
Registry record updated Dec 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT 83183 Issued in CA
Practice address
3715 Highway 4
Vallecito, CA 95251-9701
Phone
(209) 352-1828
Fax
(209) 694-4580
NPI assigned
Sep 8, 2010
Last updated
Dec 2, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 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 LMFT 83183 CA Primary

Addresses

Primary practice location

3715 Highway 4
Vallecito, CA 95251-9701

Mailing address

PO Box 551
Angels Camp, CA 95222-0551
Phone (209) 352-1828

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
I20251015002174 CA Practitioner - Marriage and Family Therapist 4880181684 Practice locations: Vallecito, CA

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Vallecito, CA 95251
Phone (209) 352-1828

PO Box
Suite 551
Angels Camp, CA 95222

PO Box
Suite 551
Angels Camp, CA 95222-0551

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
83183CAMDMental Health Counselor
LMFT 83183CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1283904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764633600000",
    "number": "1548577869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 551",
            "city": "ANGELS CAMP",
            "state": "CA",
            "postal_code": "952220551",
            "telephone_number": "209-352-1828",
            "fax_number": "209-694-4580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3715 HIGHWAY 4",
            "city": "VALLECITO",
            "state": "CA",
            "postal_code": "952519701",
            "telephone_number": "209-352-1828",
            "fax_number": "209-694-4580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MATTHEW",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-09-08",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT 83183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vallecito, CA

Sources for this page

Verify at the official NPI Registry.