Individual provider Active NPI

Camden Marie Johnson

  • Marriage & Family Therapist
  • Fresno, CA
National Provider Identifier
1831890516
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
138115 Issued in CA
Practice address
4441 E Cesar Chavez Blvd
Fresno, CA 93702-3604
Phone
(559) 600-9171
NPI assigned
Mar 10, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 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 138115 CA Primary

Addresses

Primary practice location

4441 E Cesar Chavez Blvd
Fresno, CA 93702-3604

Mailing address

4441 E Cesar Chavez Blvd
Fresno, CA 93702-3604
Phone (559) 600-9180

Other practice location 1

3133 N Millbrook Ave
Fresno, CA 93703-1425
Phone (559) 600-9180

Other practice location 2

2719 N Air Fresno Dr
Fresno, CA 93727-1547
Phone (559) 600-8918

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
138115CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1678406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1831890516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4441 E CESAR CHAVEZ BLVD",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937023604",
            "telephone_number": "559-600-9180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4441 E CESAR CHAVEZ BLVD",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937023604",
            "telephone_number": "559-600-9171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3133 N Millbrook Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937031425",
            "country_code": "US",
            "telephone_number": "559-600-9180",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2719 N Air Fresno Dr",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937271547",
            "country_code": "US",
            "telephone_number": "559-600-8918",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CAMDEN",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-10",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "138115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; 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.