Nicole Johnson
Individual provider Active NPI Marriage & Family Therapist · Pinedale, CA
NPI 1831494616 · NPPES record last updated Jul 7, 2014
Key facts
- NPI
- 1831494616
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- IMF 66166 (CA)
- Practice address
- 40 E Minarets Ave
Pinedale, CA 93650-1239 - Phone
- (559) 436-0482
- Fax
- (559) 436-4650
- NPI assigned
- Jan 25, 2011
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IMF 66166 | CA | MD | Marriage & Family Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | IMF 66166 | CA | Yes |
Addresses
Primary practice location
40 E Minarets Ave
Pinedale, CA 93650-1239
Mailing address
40 E Minarets Ave
Pinedale, CA 93650-1239
Phone (559) 436-0482
Other providers in Pinedale, CA
- Randy Hidalgo Jr.
- Patricia Huerta-Rubio
- Jerrika Jasmine Huerta
- Miriam Lizeth Ibal
- Irma Jazmin Jimenez Landeros
- Just 4 Kidz, Inc.
- Just4Kidz Inc
- Edward Kowalczyk
- Chong Lee
- Brittania Leon
All providers in Pinedale, CA · Marriage & Family Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.