Provider Demographics
NPI:1467608356
Name:JOHANSEN, NIPARPON VONGHONG (MA, LMFT, ATR)
Entity Type:Individual
Prefix:MRS
First Name:NIPARPON
Middle Name:VONGHONG
Last Name:JOHANSEN
Suffix:
Gender:F
Credentials:MA, LMFT, ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 492
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90508-0492
Mailing Address - Country:US
Mailing Address - Phone:310-480-2231
Mailing Address - Fax:310-755-3116
Practice Address - Street 1:2266 TORRANCE BLVD
Practice Address - Street 2:SUITE 3
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-2577
Practice Address - Country:US
Practice Address - Phone:310-480-2231
Practice Address - Fax:310-755-3116
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-12
Last Update Date:2017-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50783106H00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist