Provider Demographics
NPI:1811000946
Name:JOHANSEN, ANNE C (PHD MFCC)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:C
Last Name:JOHANSEN
Suffix:
Gender:F
Credentials:PHD MFCC
Other - Prefix:DR
Other - First Name:ANNE
Other - Middle Name:C
Other - Last Name:COURSO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD MFCC
Mailing Address - Street 1:17215 STUDEBAKER RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703
Mailing Address - Country:US
Mailing Address - Phone:714-651-8852
Mailing Address - Fax:562-860-1154
Practice Address - Street 1:17215 STUDEBAKER RD
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703
Practice Address - Country:US
Practice Address - Phone:714-651-8852
Practice Address - Fax:562-860-1154
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist