Provider Demographics
NPI:1437279965
Name:JOHNSON, KRISTY ANN (LMFT)
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:ANN
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 1:2101 GEER RD
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95382-2454
Mailing Address - Country:US
Mailing Address - Phone:209-664-8044
Mailing Address - Fax:209-526-0908
Practice Address - Street 1:2101 GEER RD
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382-2454
Practice Address - Country:US
Practice Address - Phone:209-664-8044
Practice Address - Fax:209-526-0908
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA90676106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist