Marian Kaye Johnson, APCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

APCC9258 Issued in CA

Practice address

3580 Shallow Creek Road
Loomis, CA 95650-9565

Phone

(916) 652-0516

Fax

(916) 652-3979

NPI assigned

Sep 9, 2021

Last updated

Sep 9, 2021By the provider in NPPES

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

Practice roles

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.

• Koinonia Foster Homes, Inc.

  dba Koinonia Homes for Teens

  • Community/Behavioral Health Agency
  • Loomis, CA
  • NPI 1942768221
  NPD
• Koinonia Foster Homes, Inc

  dba Koinonia Treatment Clinic

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Loomis, CA
  • NPI 1770787020
  NPD (past)
• Koinonia Foster Homes, Inc.

  dba Koinonia Homes for Teens

  • Foster Care Agency
  • Loomis, CA
  • NPI 1780184846
  NPD (past)

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

{
    "created_epoch": "1631145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1568131985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1403",
            "city": "LOOMIS",
            "state": "CA",
            "postal_code": "956501403",
            "telephone_number": "916-652-0171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3580 SHALLOW CREEK ROAD",
            "city": "LOOMIS",
            "state": "CA",
            "postal_code": "956509565",
            "telephone_number": "916-652-0516",
            "fax_number": "916-652-3979"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5980 Webb St",
            "address_purpose": "LOCATION",
            "city": "Loomis",
            "state": "CA",
            "postal_code": "956507625",
            "country_code": "US",
            "telephone_number": "916-652-0171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARIAN",
        "middle_name": "KAYE",
        "name_prefix": "Ms.",
        "credential": "APCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-09",
        "last_updated": "2021-09-09",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "APCC9258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie Ann Hirschaut, MD
• Farrah J Hoekstra, LCSW
• It Must Be Kismet Medical and Aesthetics, Inc.
• Denise Midori Jabusch, DDS
• Jilleen Jarrett, LCSW
• Junie Baldonado, DDS, PC
• Bianca A Kaszubinski
• Navneet Kaur
• Kevin Fleming Chiropractic, Inc
• Howard William Klein, MD

• Mental Health Counselor in Loomis, CA
• Providers in Loomis, 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 9, 2021; 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.