Provider Demographics
NPI:1053465385
Name:JOHNSON, KENNISHA ALONDA (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:KENNISHA
Middle Name:ALONDA
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 WILLOW PASS RD STE 200
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-5823
Mailing Address - Country:US
Mailing Address - Phone:925-521-5150
Mailing Address - Fax:
Practice Address - Street 1:1420 WILLOW PASS RD STE 200
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-5823
Practice Address - Country:US
Practice Address - Phone:925-521-5150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 43943106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist