Provider Demographics
NPI:1922156850
Name:JOHNSON-SIMS, MESHANETTE (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:MESHANETTE
Middle Name:
Last Name:JOHNSON-SIMS
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2751 NAPA VALLEY CORPORATE DR
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-6216
Mailing Address - Country:US
Mailing Address - Phone:707-299-1456
Mailing Address - Fax:
Practice Address - Street 1:1434 THIRD ST
Practice Address - Street 2:2A
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94559-2891
Practice Address - Country:US
Practice Address - Phone:707-280-6543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54016106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist