Active NPI
Linda Lynette Johnson
- Marriage & Family Therapist
- San Mateo, CA
National Provider Identifier
1619342516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 89367
- Practice address
- 501 1St Ave Ste 3
San Mateo, CA 94401-3476 - Phone
- (650) 504-1650
- NPI assigned
- Dec 3, 2015
- Last updated
- Apr 2, 2024
- 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 | 89367 | CA | Primary |
Addresses
Primary practice location
501 1St Ave Ste 3
San Mateo, CA 94401-3476
Mailing address
1730 Gum St
San Mateo, CA 94402-3028
Phone (650) 504-1650
Other names 1
- Linda Lynette Johnnson
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240411002914 | CA | Practitioner - Marriage and Family Therapist | 4486093309 | Practice locations: San Mateo, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Marriage and Family Therapist
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1730 Gum St
San Mateo, CA 94402-3028
Phone (650) 504-1650
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1449100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712016000000",
"number": "1619342516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1730 GUM ST",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944023028",
"telephone_number": "650-504-1650",
"fax_number": "650-345-8957"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 1ST AVE STE 3",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944013476",
"telephone_number": "650-504-1650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "LINDA",
"middle_name": "LYNETTE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-12-03",
"last_updated": "2024-04-02",
"certification_date": "2024-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "89367",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "LINDA",
"last_name": "JOHNNSON",
"middle_name": "LYNETTE",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in San Mateo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.