Provider Demographics
NPI:1568168045
Name:CHRISTINA M JOHNSON LMFT, LLC
Entity Type:Organization
Organization Name:CHRISTINA M JOHNSON LMFT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:714-345-1236
Mailing Address - Street 1:59 DAMONTE RANCH PKWY # B503
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-1907
Mailing Address - Country:US
Mailing Address - Phone:714-345-1236
Mailing Address - Fax:866-357-8606
Practice Address - Street 1:16897 ALGONQUIN ST STE L
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92649-3832
Practice Address - Country:US
Practice Address - Phone:714-345-1236
Practice Address - Fax:866-357-8606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-06
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1205961455OtherNPI
CA1972050086OtherGROUP NPI