Individual provider Active NPI

Linda Lynette Johnson

  • Marriage & Family Therapist
  • San Mateo, CA
National Provider Identifier
1619342516
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
89367 Issued in CA
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, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 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 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 Other name

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
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

Verify at the official NPI Registry.