Provider Demographics
NPI:1437299450
Name:JOHNSTON, DAVID ALAN (LMFT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:ALAN
Last Name:JOHNSTON
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 3RD ST STE 40
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-0460
Mailing Address - Country:US
Mailing Address - Phone:707-798-6488
Mailing Address - Fax:707-441-1054
Practice Address - Street 1:517 3RD ST STE 40
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-0460
Practice Address - Country:US
Practice Address - Phone:707-798-6488
Practice Address - Fax:707-441-1054
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 39235106H00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist